BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old...BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib.展开更多
目的探讨在肝移植受者术中未输注血小板(PLT)的情况下,术后早期PLT计数低对受者早期病死率的影响。方法回顾性分析接受同种异体原位肝移植的180例受者临床资料。采用受试者工作特征(ROC)曲线计算术后7 d PLT计数预测术后早期病死率的临...目的探讨在肝移植受者术中未输注血小板(PLT)的情况下,术后早期PLT计数低对受者早期病死率的影响。方法回顾性分析接受同种异体原位肝移植的180例受者临床资料。采用受试者工作特征(ROC)曲线计算术后7 d PLT计数预测术后早期病死率的临界值。根据临界值将受者分为低PLT计数组和对照组。纳入肝移植受者的相关临床资料,包括围手术期PLT计数、术前一般情况、术中情况。采用Logistic回归分析影响肝移植受者术后早期病死率的独立危险因素。观察并比较两组肝移植受者的早期预后情况,包括术后重症监护室(ICU)住院时间、术后住院时间、初期移植肝功能异常率、术后30 d病死率。结果术后7 d PLT计数<32×10^9/L是肝移植受者术后30 d病死率的独立危险因素(P<0.05)。低PLT计数组受者的术后ICU住院时间为9(5,14)d,明显长于对照组受者的5(3,6)d(P<0.05);初期移植肝功能异常率为55.0%,明显高于对照组受者的20.6%(P<0.05);术后30 d病死率为40.0%,明显高于对照组受者的2.5%(P<0.05)。两组受者间的术后住院时间差异无统计学意义(P>0.05)。结论术后7 d PLT计数<32×10^9/L是肝移植受者术后30 d病死率的独立危险因素,其可以提示术后初期移植肝功能异常,辅助预测肝移植受者早期预后。展开更多
文摘BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib.
文摘目的探讨在肝移植受者术中未输注血小板(PLT)的情况下,术后早期PLT计数低对受者早期病死率的影响。方法回顾性分析接受同种异体原位肝移植的180例受者临床资料。采用受试者工作特征(ROC)曲线计算术后7 d PLT计数预测术后早期病死率的临界值。根据临界值将受者分为低PLT计数组和对照组。纳入肝移植受者的相关临床资料,包括围手术期PLT计数、术前一般情况、术中情况。采用Logistic回归分析影响肝移植受者术后早期病死率的独立危险因素。观察并比较两组肝移植受者的早期预后情况,包括术后重症监护室(ICU)住院时间、术后住院时间、初期移植肝功能异常率、术后30 d病死率。结果术后7 d PLT计数<32×10^9/L是肝移植受者术后30 d病死率的独立危险因素(P<0.05)。低PLT计数组受者的术后ICU住院时间为9(5,14)d,明显长于对照组受者的5(3,6)d(P<0.05);初期移植肝功能异常率为55.0%,明显高于对照组受者的20.6%(P<0.05);术后30 d病死率为40.0%,明显高于对照组受者的2.5%(P<0.05)。两组受者间的术后住院时间差异无统计学意义(P>0.05)。结论术后7 d PLT计数<32×10^9/L是肝移植受者术后30 d病死率的独立危险因素,其可以提示术后初期移植肝功能异常,辅助预测肝移植受者早期预后。
