背景:阿那曲唑是一种选择性芳香化酶抑制剂,用于治疗绝经后激素敏感性乳腺癌。主要副作用包括骨质疏松症,高胆固醇血症,和肌肉骨骼事件,如关节痛和肌痛。其他不良事件很少见,包括痤疮的症状,男性化,和药物性肝损伤,后者仅在少数情况下报告。
方法:这里,我们报道了一名接受阿那曲唑治疗的患者,该患者在轻度SARS-CoV-2感染5周后通过更新的RousselUclaf因果关系评估方法评估,也就是说,据我们所知,第一份涉及阿那曲唑的报告。阿那曲唑的停药导致丙氨酸转氨酶的显着改善,和天冬氨酸转氨酶以及26天后已经观察到的正常乳酸脱氢酶血清水平。令人惊讶的是,然而,胆汁淤积血清标志物γ-谷氨酰转肽酶和碱性磷酸酶进一步升高,又花了4周时间才显著下降。
结论:本病例的介绍旨在提醒医生在阿那曲唑药物治疗的患者中出现轻度SARS-CoV-2感染后潜在的药物性肝损伤。
BACKGROUND: Anastrozole is a selective aromatase inhibitor used for the treatment of postmenopausal hormone-sensitive breast cancer. The major side effects include osteoporosis, hypercholesterolemia, and musculoskeletal events, such as arthralgia and myalgia. Other adverse events are rare, including symptoms of acne, masculinization, and drug-induced liver injury, with the latter reported in a few cases only.
METHODS: Here, we report on a patient under anastrozole therapy who developed drug-induced liver injury as assessed by the updated Roussel Uclaf Causality Assessment Method 5 weeks after a mild SARS-CoV-2 infection, which is, to the best of our knowledge, the first report of its kind involving anastrozole. Discontinuation of anastrozole resulted in a marked improvement of the alanine aminotransaminase, and aspartate aminotransaminase as well as normalized lactate dehydrogenase serum levels already seen after 26 days. Surprisingly, however, the cholestatic serum markers gamma-glutamyl transpeptidase and alkaline phosphatase showed a further rise, and took another 4 weeks to drop significantly.
CONCLUSIONS: The presentation of this
case is meant to alert physicians to a potential drug-induced liver injury following mild SARS-CoV-2 infection in patients under anastrozole medication.