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首页> 外文期刊>Acta gastro-enterologica Belgica >A rare case of drug-induced liver injury caused by an epinephrine-autoinjector
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A rare case of drug-induced liver injury caused by an epinephrine-autoinjector

机译：一种罕见的药物诱导的肝致肝损伤，由肾上腺素自身印迹引起

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To the Editor,Drag-induced liver injury (DILI) is the most common cause of acute liver failure in the USA. It is a diagnosis of exclusion based on history, physical examination, laboratory investigations and in some instances liver biopsy. Herein we present a case of a previously healthy young man who developed severe jaundice and elevated liver function tests [alanine transaminase (ALT) 700 U/L, aspartate transaminase (AST) 394 U/L, alkaline phosphatase (ALP) 636 U/L, gamma-glutamyl transpeptidase (GGT) 361 U/L, total bilirubin 26.67 mg/dL and conjugated bilirubin 16.05 mg/dL] after the inappropriate use of an epinephrine autoinjector. DILI was diagnosed after exclusion of all other possible causes. R value <2 suggestive of cholestatic liver injury, RUCAM score was 9 and consistent with high probability of DILI. Liver biopsy confirmed the diagnosis. Liver function tests returned to normal within several months. Sodium metabisulfite the preservative added to the epinephrine autoinjector has been reported to cause liver injury in an animal model. In the absence of any other medication, herbal preparation or supplements and the recent use of the epinephrine-autoinjector, sodium metabisulfite is the most likely cause of the patients DILI. Detailed history and investigations with the assistance of assessment tools led to the culprit. Preservatives and excipients used in medical preparations are not without harm and must be thoroughly evaluated in the right clinical context.
机译：向编辑，抗血管损伤（DiRi）是美国急性肝衰竭最常见的原因。它是基于历史，体检，实验室调查的排斥，以及一些肝脏活组织检查的诊断。在这里，我们提出了一个先前健康的年轻人的案例，其开发了严重的黄疸和肝功能试验[丙氨酸转氨酶（ALT）700 U / L，天冬氨酸转氨酶（AST）394 U / L，碱性磷酸酶（ALP）636 U / L. ，γ-谷氨酸缩肽酶（GGT）361 U / L，总胆红素26.67mg / dL和缀合的胆红素16.05mg / dl]在不适当的肾上腺素自身灭口器使用后。在排除所有其他可能的原因后被诊断出来的帝力。 r值<2暗示胆汁肝损伤的暗示性，Rucam得分为9，并符合帝力的高概率。肝活检证实了诊断。肝功能测试在几个月内恢复正常。据报道，乙烯基硫酸钠添加到肾上腺素自身灭口器中的防腐剂在动物模型中引起肝损伤。在没有任何其他药物的药物，草药制剂或补充剂和最近使用肾上腺素 - 自身灭绝的使用中，甲磺酸钠是患者帝力的最可能原因。在评估工具的协助下导致罪魁祸首的详细历史和调查。医疗准备中使用的防腐剂和赋形剂并非危害，必须在正确的临床环境中进行彻底评估。

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