枸地氯雷他定片致肝损伤及皮疹  

Liver injury and rashes due to desloratadine citrate disodium tablets

作　　者：张红梅[1] 刘广臣 田旭[1] 周微[1] Zhang Hongmei;Liu Guangchen;Tian Xu;Zhou Wei(Department of Pharmacy,the First Hospital of Jilin University,Changchun 130021,China;Department of Orthopedics,Wuxi Second Hospital Affiliated to Nanjing Medical University,Jiangsu Province,Wuxi 214002,China)

机构地区：[1]吉林大学第一医院药学部,长春130021 [2]南京医科大学附属无锡第二医院骨科,214002

出　　处：《药物不良反应杂志》2020年第9期533-534,共2页Adverse Drug Reactions Journal

摘　　要：1例32岁男性患者因过敏性鼻炎口服枸地氯雷他定片8.8 mg、1次/d。用药第6天腹部出现零星红色皮疹,未在意;用药第7天皮疹增多,伴瘙痒,尿液呈深棕色,双手、巩膜出现黄染。实验室检查示丙氨酸转氨酶(ALT)323 U/L,天冬氨酸转氨酶(AST)186 U/L,γ‑谷氨酰转移酶(γ‑GT)309 U/L,总胆红素(TBil)63.9μmol/L,直接胆红素(DBil)33.6μmol/L,诊断:药物性肝损伤,过敏性皮炎。考虑为枸地氯雷他定所致,停用该药,给予保肝治疗及糠酸莫米松乳膏外涂。停用枸地氯雷他定第2天,患者尿液颜色变浅;第4天皮疹颜色变浅,尿液颜色恢复正常,无新发皮疹;第9天皮疹基本消退,肝功能检查示ALT 84 U/L,AST 29 U/L,γ‑GT 187 U/L,TBil 19.5μmol/L,DBil 8.0μmol/L。2周后复查:ALT 54 U/L,其他检查结果均在参考值范围内。A 32‑year‑old male patient received oral desloratadine citrate disodium tablets 8.8 mg once daily for allergic rhinitis.On the 6th day of medication,he developed sporadic red rashes on his abdomen,but he didn′t pay attention to it.On the 7th day of medication,the rashes increased and were with itching;urine color became dark brown;and he developed yellowish discoloration of hand skin and sclera.Laboratory tests showed alanine aminotransferase(ALT)323 U/L,aspartate aminotransferase(AST)186 U/L,gamma glutamyl transferase(γ‑GT)309 U/L,total bilirubin(TBil)63.9μmol/L,and direct bilirubin(DBil)33.6μmol/L.He was diagnosed as having drug‑induced liver injury and allergic dermatitis,which were considered to be caused by desloratadine citrate disodium.Then the drug was stopped and the patient was given liver‑protective treatments and external application of mometasone furoate cream.On day 2 of desloratadine citrate disodium withdrawal,the color of his urine became lighter.On day 4 of drug withdrawal,the color of the rashes became lighter,the color of urine returned to normal,and there were no new rashes.On day 9 of drug withdrawal,the rashes disappeared basically.Liver function examination showed ALT 84 U/L,AST 29 U/L,γ‑GT 187 U/L,TBil 19.5μmol/L,and DBil 8.0μmol/L.Two weeks later,his ALT was 54 U/L,and other examination results were within the reference fange.

关 键 词：氯雷他定 化学和药物性肝损伤 药疹 

分 类 号：R969[医药卫生—药理学]