摘要
1例29岁女性患者因甲状腺功能亢进遵医嘱口服甲巯咪唑20 mg、1次/d,用药前肝功能正常.用药14 d后,患者血清ALT 122 U/L,AST 87 U/L,停用甲巯咪唑并予保肝治疗.9 d后,患者ALT 42 U/L,AST 35 U/L,遵医嘱再次口服甲巯咪唑片10 mg、1次/d.再次用药第9天,患者全身出现皮疹伴瘙痒,右肘关节疼痛、活动受限,双肩关节及膝关节疼痛,实验室检查示ALT 134 U/L,AST 109 U/L,诊断为药物性肝损伤、药物性皮疹和药物相关关节炎综合征.再次停用甲巯咪唑,给予抗过敏、保肝及止痛治疗.10 d后,患者皮疹基本消退,ALT 36 U/L,AST 24 U/L,关节疼痛稍有改善,可自主活动,偶有活动受限.
A 29-year-old female patient with hyperthyroidism received methimazole 20 mg once daily according to the doctor′s advice. Her liver function was normal before drug administration. Fourteen days after medication,the results of laboratory test showed that ALT was 122 U/ L,AST 87 U/ L. Methimazole was stopped and liver protection treatment was given. Nine days later,her ALT and AST were 42 U/ L and 35 U/ L,respectively. She received methimazole 10 mg once daily again. On day 9 of remedication,the patient developed rash with pruritus,pain and limitation of activity on the right elbow joint,pain on the bilateral shoulder joints and the knee joints,and laboratory test showed ALT 134 U/ L,and AST 109 U/ L. She was diagnosed as drug induced liver injury,drug rash,and drug related arthritis syndrome. Methimazole was stopped again. The patient received the treatments of antianaphylaxis,liver protection and analgesic. Ten days later,her rash mostly disappeared. Laboratory test showed ALT 36 U/ L and AST 24 U/ L. Her arthralgia was improved slightly,could move intentionally,but activity was limitated occasionally.
出处
《药物不良反应杂志》
CSCD
2017年第6期473-474,共2页
Adverse Drug Reactions Journal
关键词
甲巯咪唑
药疹
药物性肝损伤
关节炎
Methimazole
Drug erupsions
Drug-induced liver injury
Arthritis
