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首页> 外文期刊>Eastern Journal of Medicine >Early onset hepatotoxicity associated with low dose fluconazole therapy in a critically ill patient: A case report
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Early onset hepatotoxicity associated with low dose fluconazole therapy in a critically ill patient: A case report

机译：低剂量氟康唑治疗危重病人的早期肝毒性：一例报告

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Early onset hepatotoxicity associated with low dose fluconazole therapy in a critically ill patient: A case report Jaime Yoke May Chan 1 , Chai Fung Kiew 1 , Chee Ping Chong 1 Hepatoxicity associated with fluconazole is less implicated than other antifungals although cases of fatalities were reported. We describe a 34-year-old kidney impaired male with Marfan syndrome manifested with elevated liver enzymes due to fluconazole therapy intravenous (IV) 200 mg stat followed by IV 100 mg daily. His baseline alanine aminotransferase (ALT) was 38 U/L, total bilirubin was 36 μmol/L and prothrombin time was 19.7 seconds. Marked elevation of ALT level (214 U/L), total bilirubin (54 μmol/L) and prothrombin time (37 seconds) were noticed starting from day 4 of fluconazole therapy. The patient subsequently developed nausea and vomiting; ALT and total bilirubin level further rose to 2394 U/L and 94 μmol/L on day 6. Discontinuation of fluconazole without rechallenged on day 8 resulted in sharp decreased in prothrombin time from 65.3 seconds to 31.9 seconds and normalization of liver enzymes in 2 weeks time. In conclusion, low dose fluconazole may induce early onset of hepatotoxicity in critically ill patient with kidney damage. Prompt discontinuation of fluconazole therapy is needed to prevent further deterioration in liver function.
机译：危重病人低剂量氟康唑治疗相关的早期肝毒性：病例报告Jaime Yoke May Chan 1 ，柴凤秋 1 ，Chee Ping Chong 1 尽管已报告有死亡病例，但与氟康唑相关的肝毒性比其他抗真菌药的影响要小。我们描述了一名34岁的患有马凡氏综合征的肾功能受损的男性，由于氟康唑治疗的静脉（IV）200 mg静注后每日100 mg静脉注脂，肝酶水平升高。他的基线丙氨酸氨基转移酶（ALT）为38 U / L，总胆红素为36μmol/ L，凝血酶原时间为19.7秒。从氟康唑治疗的第4天开始，ALT水平（214 U / L），总胆红素（54μmol/ L）和凝血酶原时间（37秒）明显升高。患者随后出现恶心和呕吐。 ALT和总胆红素水平在第6天进一步升至2394 U / L和94μmol/ L。在第8天停用氟康唑但未引起挑战，导致凝血酶原时间从65.3秒急剧减少至31.9秒，并且肝酶在2周内恢复正常时间。总之，低剂量氟康唑可在患有肾脏损害的危重患者中诱发肝毒性的早期发作。需要立即终止氟康唑治疗，以防止肝功能进一步恶化。

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