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題名 | Leflunomide Induced Acute Hepatic Failure: A Case Report |
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作者姓名(中文) | 劉慧萍; 謝坤屏; 蔡斌智; | 書刊名 | 藥學雜誌 |
卷期 | 26:1=102 2010.03[民99.03] |
頁次 | 頁8-13 |
分類號 | 418.29 |
關鍵詞 | 類風濕性關節炎; 風濕疾病修飾藥; 免疫抑制劑; Hepatic failure; Hepatic toxicity; Rheumatoid arthritis; Disease-modifying antirheumatic drug; |
語文 | 英文(English) |
中文摘要 | Leflunomide是針對潛在病因進行改善疾病修飾的抗類風濕性關節炎藥品,服用後經由肝快速代謝成活性代謝物 A771726,此代謝物因具有較長之半衰期,因此對於肝臟有潛在的蓄積毒性。本案例為五十三歲男性,因風濕性關節炎而使用 leflunomide治療,於服藥後一個半月出現黃疸症狀以及肝功能指數異常, Naranjo scale評估為極可能 (Probalbe)是leflunomide引起的急性肝衰竭。自 leflunomide上市後,其在肝毒性之副作用已逐漸引起重視及警惕,希望藉此病例報告能提醒使用 leflunomide時應注意監測病患肝功能的變化。 |
英文摘要 | Leflunomide, a new class of disease-modifying antirheumatic drug (DMARD), used in the treatment of active rheumatoid arthritis (RA). It is a prodrug that is rapidly metabolized to an active metabolite, A771726 with a long elimination half-life; therefore, serious adverse events may occur even after leflunomide treatment has been stopped. In this case report, leflunomide was prescribed to a 53-yearsold male patient with history of RA. Unfortunately, forty-five days later he developed a progressive jaundice with elevated liver enzymes. Then acute hepatic failure with liver damage was diagnosed in the following weeks. Leflunomide has commonly been associated with hepatic toxicity. This case was reporting the acute hepatic failure associated with leflunomide, therefore, we strongly recommend health care physician to routinely monitor patient's liver function for minimizing the potential hepatotoxicity with leflunomide therapy. |
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