CYP2C19 Genotyping Plus Therapeutic Drug Monitoring Dependent Voriconazole Treatment for Invasive Pulmonary Aspergillosis in a Patient with Liver Failure  

作　　者：Chuan Shen Qian Zhao Ziyue Li Wei Wang Yalin Zhao Lingya Kong Jing Xie Caiyan Zhao 

机构地区：[1]Department of Infectious Disease,Third Affiliated Hospital of Hebei Medical University,Shijiazhuang 050051,China [2]Clinical Research Center for Infectious Disease of Hebei Province,Shijiazhuang 050051,China [3]Office of Quality Management and Control in Healthcare,Third Affiliated Hospital of Hebei Medical University,Shijiazhuang 050051,China

出　　处：《Infectious Diseases & Immunity》2022年第2期125-128,共4页感染性疾病与免疫（英文）

基　　金：This work was supported by the National Natural Science Foundation of China(No.81900536).

摘　　要：Invasive pulmonary aspergillosis(IPA)is a lethal infectious disease with high mortality in patients with liver failure.Early recognition of the risk factors prompting earlier diagnosis and treatment may improve the outcomes.Voriconazole is recommended as the first-line drug for IPA,but hepatotoxicity limits its use in the context of liver diseases.We report a case of a 63-year-old female who was admitted to the Third Affiliated Hospital of Hebei Medical University due to IPA after glucocorticoid therapy for liver failure.The polymorphism of cytochrome P450(CYP)isoenzymes showed CYP2C19∗1/∗2 genotype associated with intermediate metabolism of voriconazole.However,the patient developed side effects such as skin rash,vomiting,hyperbilirubinemia,and alteration of consciousness,even if she received half of the recommended dosage for voriconazole.Therapeutic drug monitoring(TDM)was applied to guide the dosage adjustment of voriconazole in this patient,and consequently,the patient presented a favorable outcome.In conclusion,genotyping screening plus TDM dependent individualized treatment of voriconazole may improve the survival of liver failure patient with IPA.

关 键 词：Invasive pulmonary aspergillosis Liver failure Therapeutic drug monitoring VORICONAZOLE 

分 类 号：R575.3[医药卫生—消化系统]