PDF(Pubmed)
Abstract：
BACKGROUND: Sacubitril/valsartan (Entresto) is the first drug approved for the treatment of symptomatic chronic heart failure with reduced ejection fraction in adult patients. There have been no reports of hepatotoxicity secondary to sacubitril/valsartan administration. Here, we report the first case of severe liver injury caused by sacubitril/valsartan.
METHODS: A 90-year-old female patient taking sacubitril/valsartan was admitted due to chronic heart failure. Subsequently, the patient developed serious liver injury with increased hepatic transaminases.
METHODS: Drug-induced liver injury, sacubitril/valsartan-related. No liver injury caused by other reasons was observed after thorough examination. After the withdrawal of sacubitril/valsartan, the liver function of the patient gradually returned to normal.
METHODS: We chose general liver protection methods to improve her hepatic function, including magnesium isoglycyrrhizinate at 100 mg daily and polyene phosphatidylcholine capsules at 456 mg 3 times daily. We consulted with a hepatologist to discuss the best plan for her treatment. The last, we stopped sacubitril/valsartan.
RESULTS: After the withdrawal of sacubitril/valsartan, the liver function of the patient gradually returned to normal.
CONCLUSIONS: Sacubitril/valsartan-induced liver injury is very rare. Clinicians should pay particular attention to the possibility of hepatotoxicity during sacubitril/valsartan treatment.
METHODS: A 90-year-old female patient taking sacubitril/valsartan was admitted due to chronic heart failure. Subsequently, the patient developed serious liver injury with increased hepatic transaminases.
METHODS: Drug-induced liver injury, sacubitril/valsartan-related. No liver injury caused by other reasons was observed after thorough examination. After the withdrawal of sacubitril/valsartan, the liver function of the patient gradually returned to normal.
METHODS: We chose general liver protection methods to improve her hepatic function, including magnesium isoglycyrrhizinate at 100 mg daily and polyene phosphatidylcholine capsules at 456 mg 3 times daily. We consulted with a hepatologist to discuss the best plan for her treatment. The last, we stopped sacubitril/valsartan.
RESULTS: After the withdrawal of sacubitril/valsartan, the liver function of the patient gradually returned to normal.
CONCLUSIONS: Sacubitril/valsartan-induced liver injury is very rare. Clinicians should pay particular attention to the possibility of hepatotoxicity during sacubitril/valsartan treatment.
摘要：
背景：沙库必曲/缬沙坦（Entresto）是第一种被批准用于治疗成年患者射血分数降低的有症状慢性心力衰竭的药物。尚无沙库必曲/缬沙坦给药继发肝毒性的报道。这里,我们报告了首例沙库必曲/缬沙坦引起的严重肝损伤。
方法：一名服用沙库巴曲/缬沙坦的90岁女性患者因慢性心力衰竭入院。随后，患者出现严重的肝损伤，肝转氨酶升高。
方法：药物性肝损伤，沙库必曲/缬沙坦相关。彻底检查后未观察到其他原因引起的肝损伤。沙库必曲/缬沙坦停药后，患者肝功能逐渐恢复正常。
方法：我们选择了一般的肝脏保护方法来改善她的肝功能，包括异甘草酸镁每天100毫克和多烯磷脂酰胆碱胶囊456毫克每天3次。我们咨询了一位肝病专家，讨论了她治疗的最佳方案。最后,我们停止了沙库巴曲/缬沙坦。
结果：沙库巴曲/缬沙坦停药后，患者肝功能逐渐恢复正常。
结论：沙巴曲/缬沙坦诱导的肝损伤非常罕见。临床医生应特别注意沙库巴曲/缬沙坦治疗期间肝毒性的可能性。
方法：一名服用沙库巴曲/缬沙坦的90岁女性患者因慢性心力衰竭入院。随后，患者出现严重的肝损伤，肝转氨酶升高。
方法：药物性肝损伤，沙库必曲/缬沙坦相关。彻底检查后未观察到其他原因引起的肝损伤。沙库必曲/缬沙坦停药后，患者肝功能逐渐恢复正常。
方法：我们选择了一般的肝脏保护方法来改善她的肝功能，包括异甘草酸镁每天100毫克和多烯磷脂酰胆碱胶囊456毫克每天3次。我们咨询了一位肝病专家，讨论了她治疗的最佳方案。最后,我们停止了沙库巴曲/缬沙坦。
结果：沙库巴曲/缬沙坦停药后，患者肝功能逐渐恢复正常。
结论：沙巴曲/缬沙坦诱导的肝损伤非常罕见。临床医生应特别注意沙库巴曲/缬沙坦治疗期间肝毒性的可能性。
