目前,国内尚无关于九价人乳头瘤病毒疫苗导致药物性肝损伤的报道,但这一问题应引起临床医师的高度重视。现报道1例中年女性患者,在接种九价HPV疫苗第二针后出现乏力、纳差、巩膜及皮肤黄染,经护肝、利胆等对症支持治疗后症状好转,但临...目前,国内尚无关于九价人乳头瘤病毒疫苗导致药物性肝损伤的报道,但这一问题应引起临床医师的高度重视。现报道1例中年女性患者,在接种九价HPV疫苗第二针后出现乏力、纳差、巩膜及皮肤黄染,经护肝、利胆等对症支持治疗后症状好转,但临床医生未能及时说服患者完善相关检查进一步排查药物性肝损伤,致患者继续接种第三针,出现肝损慢性化、严重化。经进一步的护肝、利胆、营养支持等对症支持治疗并随访5个月,患者肝脏功能已恢复正常。通过该病例以期提高临床对药物性肝损伤的认知及诊治水平。At present, there is no report on drug-induced liver injury caused by nine-valent human papillomavirus vaccine in China, but this problem should be highly valued by clinicians. It is reported that a middle-aged female patient suffered from fatigue, poor appetite, yellow staining of sclera and skin after the second dose of nine-valent HPV vaccine. After symptomatic support treatment such as protecting the liver and promoting gallbladder function, the symptoms improved, but the clinician failed to persuade the patient to improve the relevant examination in time to further investigate the drug-induced liver injury, resulting in the patient continuing to receive the third dose, resulting in chronic and severe liver damage. After further symptomatic support treatment such as liver protection, choleretic and nutritional support and follow-up for 5 months, the liver function of the patient has returned to normal. Through this case, we hope to improve the clinical cognition, diagnosis and treatment of drug-induced liver injury.展开更多
文章详细报道了一例在使用抗结核药物后出现药疹并发肝损伤的病例。患者在抗结核治疗期间,出现类似皮肤过敏反应的症状,经详细检查和评估,考虑为抗结核药物导致的药物性皮疹同时并发肝损伤。经对症处理及保肝治疗后,患者药疹症状缓解,...文章详细报道了一例在使用抗结核药物后出现药疹并发肝损伤的病例。患者在抗结核治疗期间,出现类似皮肤过敏反应的症状,经详细检查和评估,考虑为抗结核药物导致的药物性皮疹同时并发肝损伤。经对症处理及保肝治疗后,患者药疹症状缓解,待肝功能恢复正常,通过药物激发试验,给患者逐一试用抗结核药物并重新引入抗痨方案。本病例提示临床医生在使用抗结核药物时,需密切关注患者的皮肤状况及肝肾功能指标,以早期发现并处理药物不良反应。且通过对该病例的诊断和治疗过程进行详细地分析和总结,旨在增强临床工作者对抗结核药使用过程中可能出现的副作用的认识,并为临床实践提供参考和借鉴。A case of drug-induced rash and concomitant liver injury following anti-TB therapy was reported in detail. During treatment, the patient developed symptoms resembling a skin allergic reaction. Comprehensive examination and evaluation confirmed that the rash and liver injury were caused by anti-TB drugs. Symptomatic management and hepatoprotective treatment were provided, resulting in symptom resolution. Once liver function normalized, anti-TB drugs were reintroduced sequentially through drug challenge tests, and the anti-TB regimen was successfully restructured. This case underscored the need for clinicians to closely monitor skin and hepatic function during anti-TB therapy to detect and manage adverse drug reactions early. The detailed analysis of this case aimed to enhance clinical awareness of potential adverse effects associated with anti-TB drugs and provide practical guidance for clinical decision-making.展开更多
文摘目前,国内尚无关于九价人乳头瘤病毒疫苗导致药物性肝损伤的报道,但这一问题应引起临床医师的高度重视。现报道1例中年女性患者,在接种九价HPV疫苗第二针后出现乏力、纳差、巩膜及皮肤黄染,经护肝、利胆等对症支持治疗后症状好转,但临床医生未能及时说服患者完善相关检查进一步排查药物性肝损伤,致患者继续接种第三针,出现肝损慢性化、严重化。经进一步的护肝、利胆、营养支持等对症支持治疗并随访5个月,患者肝脏功能已恢复正常。通过该病例以期提高临床对药物性肝损伤的认知及诊治水平。At present, there is no report on drug-induced liver injury caused by nine-valent human papillomavirus vaccine in China, but this problem should be highly valued by clinicians. It is reported that a middle-aged female patient suffered from fatigue, poor appetite, yellow staining of sclera and skin after the second dose of nine-valent HPV vaccine. After symptomatic support treatment such as protecting the liver and promoting gallbladder function, the symptoms improved, but the clinician failed to persuade the patient to improve the relevant examination in time to further investigate the drug-induced liver injury, resulting in the patient continuing to receive the third dose, resulting in chronic and severe liver damage. After further symptomatic support treatment such as liver protection, choleretic and nutritional support and follow-up for 5 months, the liver function of the patient has returned to normal. Through this case, we hope to improve the clinical cognition, diagnosis and treatment of drug-induced liver injury.
文摘文章详细报道了一例在使用抗结核药物后出现药疹并发肝损伤的病例。患者在抗结核治疗期间,出现类似皮肤过敏反应的症状,经详细检查和评估,考虑为抗结核药物导致的药物性皮疹同时并发肝损伤。经对症处理及保肝治疗后,患者药疹症状缓解,待肝功能恢复正常,通过药物激发试验,给患者逐一试用抗结核药物并重新引入抗痨方案。本病例提示临床医生在使用抗结核药物时,需密切关注患者的皮肤状况及肝肾功能指标,以早期发现并处理药物不良反应。且通过对该病例的诊断和治疗过程进行详细地分析和总结,旨在增强临床工作者对抗结核药使用过程中可能出现的副作用的认识,并为临床实践提供参考和借鉴。A case of drug-induced rash and concomitant liver injury following anti-TB therapy was reported in detail. During treatment, the patient developed symptoms resembling a skin allergic reaction. Comprehensive examination and evaluation confirmed that the rash and liver injury were caused by anti-TB drugs. Symptomatic management and hepatoprotective treatment were provided, resulting in symptom resolution. Once liver function normalized, anti-TB drugs were reintroduced sequentially through drug challenge tests, and the anti-TB regimen was successfully restructured. This case underscored the need for clinicians to closely monitor skin and hepatic function during anti-TB therapy to detect and manage adverse drug reactions early. The detailed analysis of this case aimed to enhance clinical awareness of potential adverse effects associated with anti-TB drugs and provide practical guidance for clinical decision-making.
