PDF(Pubmed)
Abstract：
UNASSIGNED: Drug-induced liver injury (DILI) associated with 5-aminosalicylic acid (5-ASA) is a rare but potentially life-threatening adverse event.
UNASSIGNED: We report the case of a 58-year-old woman with ulcerative colitis who developed DILI after initiating maintenance therapy with the multimatrix system 5-ASA. The patient presented with grade 4 liver enzyme elevation on day 98 after initiating 5-ASA and was admitted to the hospital. Blood tests revealed the mixed liver injury, and imaging studies showed no abnormalities except for mild lymph node enlargement. Liver biopsy revealed acute lobular hepatitis with interfacial activity. The patient\'s score on the International Autoimmune Hepatitis Group 1999 revised scoring system was a total score of 10, causing a suspicion for the diagnosis of autoimmune hepatitis. The DDW-J 2004 scale calculated a total score of six, indicating a high probability of DILI. We suspected DILI due to 5-ASA, and the 5-ASA formulations were discontinued. The patient was treated with ursodeoxycholic acid and neominophagen C, and her liver function gradually improved without steroid treatment. Finally, we definitively diagnosed DILI based on the pathological findings and clinical course after discontinuation of 5-ASA.
UNASSIGNED: This case highlights the importance of monitoring liver function in patients receiving 5-ASA therapy.
UNASSIGNED: We report the case of a 58-year-old woman with ulcerative colitis who developed DILI after initiating maintenance therapy with the multimatrix system 5-ASA. The patient presented with grade 4 liver enzyme elevation on day 98 after initiating 5-ASA and was admitted to the hospital. Blood tests revealed the mixed liver injury, and imaging studies showed no abnormalities except for mild lymph node enlargement. Liver biopsy revealed acute lobular hepatitis with interfacial activity. The patient\'s score on the International Autoimmune Hepatitis Group 1999 revised scoring system was a total score of 10, causing a suspicion for the diagnosis of autoimmune hepatitis. The DDW-J 2004 scale calculated a total score of six, indicating a high probability of DILI. We suspected DILI due to 5-ASA, and the 5-ASA formulations were discontinued. The patient was treated with ursodeoxycholic acid and neominophagen C, and her liver function gradually improved without steroid treatment. Finally, we definitively diagnosed DILI based on the pathological findings and clinical course after discontinuation of 5-ASA.
UNASSIGNED: This case highlights the importance of monitoring liver function in patients receiving 5-ASA therapy.
摘要：
■与5-氨基水杨酸（5-ASA）相关的药物性肝损伤（DILI）是一种罕见但可能危及生命的不良事件。
■我们报告了一例58岁女性溃疡性结肠炎，在开始使用多基质系统5-ASA维持治疗后出现DILI。该患者在开始5-ASA后第98天出现4级肝酶升高并入院。血液检查显示混合肝损伤,影像学检查显示，除轻度淋巴结肿大外，无异常。肝活检显示急性小叶性肝炎具有界面活性。在1999年国际自身免疫性肝炎组修订的评分系统上，患者的评分为10分，这引起了对自身免疫性肝炎诊断的怀疑。DDW-J2004量表计算的总分为6分，表明DILI的可能性很高。我们怀疑DILI是因为5-ASA，并且停用5-ASA制剂。该患者接受熊去氧胆酸和新霉素C治疗，在没有类固醇治疗的情况下，她的肝功能逐渐改善。最后,我们根据5-ASA停药后的病理结果和临床病程明确诊断DILI.
■这个案例突出了监测接受5-ASA治疗的患者肝功能的重要性。
■我们报告了一例58岁女性溃疡性结肠炎，在开始使用多基质系统5-ASA维持治疗后出现DILI。该患者在开始5-ASA后第98天出现4级肝酶升高并入院。血液检查显示混合肝损伤,影像学检查显示，除轻度淋巴结肿大外，无异常。肝活检显示急性小叶性肝炎具有界面活性。在1999年国际自身免疫性肝炎组修订的评分系统上，患者的评分为10分，这引起了对自身免疫性肝炎诊断的怀疑。DDW-J2004量表计算的总分为6分，表明DILI的可能性很高。我们怀疑DILI是因为5-ASA，并且停用5-ASA制剂。该患者接受熊去氧胆酸和新霉素C治疗，在没有类固醇治疗的情况下，她的肝功能逐渐改善。最后,我们根据5-ASA停药后的病理结果和临床病程明确诊断DILI.
■这个案例突出了监测接受5-ASA治疗的患者肝功能的重要性。
