伊布替尼致重度肝损害1例附文献分析

Severe Liver Injury Caused by Ibrutinib Case Report and Literature Analysis

目的:探讨伊布替尼导致肝损害的临床特征并分析伊布替尼导致肝损害的特点及可能机制,以期为临床合理用药提供参考。方法:基于我院1例患者应用伊布替尼治疗滤泡细胞淋巴瘤过程中出现严重胆汁淤积性肝损害的案例,综合分析患者服用伊布替尼后出现肝损害后相关指标变化,并结合国内外伊布替尼引起肝损害的案例报道分析,探讨伊布替尼导致肝损害的特点及可能机制。结果:本例患者服用伊布替尼72 d后出现胆红素、胆汁酸和转氨酶上升,彩超提示弥漫性肝损害。结论:伊布替尼服用后虽然很少出现因药物不良反应停药现象,但可能在肝脏中蓄积,进而导致肝损害的发生。建议临床上使用伊布替尼时,检测肝功能尤为必要,特别是对于基线时肝功能就出现异常的患者。

Objective:To investigate the clinical features of ibrutinib-induced liver injury and to analyze its characteristics and possible pathogenesis.Methods:Based on a case of severe cholestatic liver injury in a patient with follicular cell lymphoma treated with ibrutinib,the changes in relevant indicators of liver injury after taking ibrutinib were comprehensive analyzed,and combined with the case report of liver injury cause by ibrutinib at home and abroad,to investigate the characteristics and possible mechanism of ibrutinib-induced liver injury.Results:The patient showed an increase in bilirubin,bile acid and transaminase 72 d after taking ibrutinib.Doppler ultrasonography image showed diffuse liver damage.Conclusion:Although the withdrawal of ibrutinib due to side effects is rare,it may accumulate in the liver and lead to liver injury.It is suggested that it is necessary to detect liver function when using ibrutinib clinically,especially in patients with abnormal liver function at baseline.