利伐沙班治疗后急性肝衰竭一例报告及文献回顾

M. Baig, K. Wool, J. Halanych, Rehan Sarmad
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引用次数: 17

摘要

背景:利伐沙班是一种被批准用于预防血栓栓塞的直接Xa因子抑制剂。近年来,利伐沙班药物性肝损伤的报道越来越多,但实际的肝衰竭尚未见报道。病例报告:我们提出一个病例报告可能发生急性肝衰竭与利伐沙班治疗。一名89岁的房颤病史妇女因双室充血性心力衰竭合并被动肝充血而住院,对速尿有反应。她出院后使用利伐沙班预防血栓栓塞。出院时肝功能检查几乎恢复正常。一周后,患者出现腹痛,肝酶升高,胆红素升高,凝血异常。一天后,她出现肝性脑病,提示肝功能衰竭。结论:肝酶随停药迅速下降,但患者因多器官功能衰竭而死亡。该患者的因果关系评估为“可能”使用利伐沙班。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute Liver Failure after Initiation of Rivaroxaban: A Case Report and Review of the Literature
Context: Rivaroxaban is a direct factor Xa inhibitor approved for the prevention of thromboembolism. Drug induced liver injury has been increasingly reported with rivaroxaban recently, but actual liver failure has not been reported. Case Report: We present a case report on the probable occurrence of acute liver failure with rivaroxaban therapy. An 89 year old woman with history of atrial fibrillation was hospitalized for biventricular congestive heart failure with passive congestion of liver, which responded to furosemide. She was discharged home on rivaroxaban for prevention of thrombo-embolism. Liver function tests upon discharge returned to almost normal range. One week later, she presented with abdominal pain and was found to have highly elevated liver enzymes, elevated bilirubin, and an abnormal coagulation profile. A day later, she developed hepatic encephalopathy, suggesting liver failure. Conclusion: Liver enzymes declined rapidly with the discontinuation of all of her medications, however patient died because of multi-organ failure. The causality assessment in this patient was "probable" with rivaroxaban.
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