吉非替尼片致严重血清转氨酶升高伴急性胆囊炎1例分析

doi:10.19803/j.1672-8629.2021.06.19

中国药物警戒 ›› 2021, Vol. 18 ›› Issue (6): 584-587.
DOI: 10.19803/j.1672-8629.2021.06.19

吉非替尼片致严重血清转氨酶升高伴急性胆囊炎1例分析

廖玉芳¹, 岳建农², 司可^3,*

重庆市黔江中心医院,¹药学部;
²医保办;
³重症医学科,重庆黔江 409099

收稿日期:2019-12-13 出版日期:2021-06-15 发布日期:2021-07-02
通讯作者: ^*司可,女,护师,重症医学。E-mail：117411799@qq.com
作者简介:廖玉芳,男,硕士,主管药师,肿瘤临床药学。
基金资助:
重庆市卫生计生委-医学科研项目基金（2015MSXM135）; 重庆市黔江区科技局科研项目基金（2019054）

One Case of Severe Serum Transaminase Elevation with Acute Cholecystitis Induced by Gefitinib Tablets

LIAO Yufang¹, YUE Jiannong², SI Ke^3,*

¹Department of Pharmacy,
²Medical Insurance Office,
³Intensive Care Unit, Chongqing Qianjiang Central Hospital, Qianjiang Chongqing 409099, China

Received:2019-12-13 Online:2021-06-15 Published:2021-07-02

摘要/Abstract

摘要： 目的探讨吉非替尼引起严重血清转氨酶升高伴急性胆囊炎的机制和诊疗措施。方法临床药师对1例长期口服吉非替尼后出现严重血清转氨酶升高伴急性胆囊炎进行分析,复习相关文献,探讨吉非替尼诱发肝损伤合并胆囊炎的发病机制及处置措施,为临床医生用药提供参考。结果吉非替尼引起血清转氨酶严重升高伴急性胆囊炎是一种罕见的严重不良反应,通过停用吉非替尼并给予积极保肝治疗后,患者肝胆情况得到明显恢复。结论本病例是吉非替尼罕见不良反应,并在临床应用中提出新的药学监护要点,对保证患者用药安全具有积极作用。

关键词: 吉非替尼, 转氨酶, 急性胆囊炎, 药品不良反应, 药学监护

Abstract: Objective To investigate the mechanism and treatments of severe serum transaminase elevation complicated with acute cholecystitis induced by gefitinib. Methods The clinical pharmacist analyzed one case of severe serum transaminase elevation complicated with acute cholecystitis after receiving long-term oral gefitinib. The related literature was reviewed, while the pathogenesis and treatments of gefitinib-induced liver injury with cholecystitis were explored. Results Gefitinib-caused severe elevation of serum transaminase with acute cholecystitis was a rare serious adverse reaction. After gefitinib was discontinued and active hepatoprotective treatment was adopted, the patient’s liver and gallbladder condition was significantly improved. Conclusion This case is a rare adverse reaction of gefitinib, and new priorities of pharmaceutical care have been proposed in clinical application, which can contribute to ensuring the safety of patients' medication.

Key words: cefitinib, transaminase, acute cholecystitis, adverse drug reactions, pharmaceutical care

中图分类号:

R994.11

廖玉芳, 岳建农, 司可. 吉非替尼片致严重血清转氨酶升高伴急性胆囊炎1例分析[J]. 中国药物警戒, 2021, 18(6): 584-587.

LIAO Yufang, YUE Jiannong, SI Ke. One Case of Severe Serum Transaminase Elevation with Acute Cholecystitis Induced by Gefitinib Tablets[J]. Chinese Journal of Pharmacovigilance, 2021, 18(6): 584-587.

参考文献

[1] Freddie B, Jacques F, Isabelle S, et al.Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA: A Cancer Journal for Clinicians, 2018, 68(6): 394-424.
[2] Xiao X, He Z, Cao W, et al.Oridonin inhibits gefitinib-resistant lung cancer cells by suppressing EGFR/ERK/MMP-12 and CIP2A/Akt signaling pathways[J]. International Journal of Oncology, 2016, 48(6): 2608-2618.
[3] Lopez SC, Baro M, Quijano A, et al.Oligosaccharyl transferase inhibition overcomes therapeutic resistance to EGFR tyrosine Kinase inhibitors[J]. Cancer Research, 2018, 78(17): 5094-5106.
[4] Chen C, He ZW.Research progress on the mechanism of acquired drug resistance of gefitinib in the treatment of non-small cell lung cancer[J]. Journal of Guangdong Medical University(广东医科大学学报) ,2020, 38(4): 377-385.
[5] Yu F, Liu JB, Wu ZJ, et al.Tumor suppressive microRNA-124a inhibits stemness and enhances gefitinib sensitivity of non-small cell lung cancer cells by targeting ubiquitin-specific protease 14[J]. Cancer Letters, 2018, 427(7): 74-84.
[6] Xia HH.Literature analysis of 82 cases of adverse drug reactions induced by gefifitinib[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2016, 13(2): 98-102.
[7] Ge JB, Xu YJ. Internal Medicine(内科学)[M]. Beijing: People's Medical Publishing House, 2013: 205-206.
[8] Wang JF.Analysis of 1 case of liver injury induced by gefitinib[J]. Asia Pacific Traditional Medicine(亚太传统医药), 2014, 10(7): 96-98.
[9] Wang J, Wu Y, Dong M, et al.Observation of hepatotoxicity during long-term gefitinib administration in patients with non-small-cell lung cancer[J]. Anticancer Drugs, 2016, 27(3): 245-250.
[10] Chen J, Gu R, Wang Q, et al.Gefitinib-induced hepatotoxicity in patients treated for non-small cell lung cancer[J]. Onkologie, 2012, 35(9): 509-513.
[11] Cheng SJ, Kong XM, Dong XJ, et al.The study of pathology and enzymic histochemistry of cholecystttis caused by different drugs[J]. Acta Veterinaria et Zootechnica Sinica(畜牧兽医学报), 1999, 30(2): 139-145.
[12] Li R, Hu QF.Cholecystitis induced by hepatic artery chemo-therapy[J]. Journal of Shihezi Medical College(石河子医学院学报), 1989, 11(1): 21-22.
[13] Wen JF, Tang JW, Lai MD, et al.Pathology(病理学)[M] Beijing: People's Medical Publishing House, 2013: 416-417.
[14] Danan G, Benichou C.Causality assessment of adverse reactions to drugs I. A novel method based on the conclusions of international consensus meetings: application to drug induced liver injuries[J]. Journal of Clinical Epidemiology, 1993, 46(11): 1323-1330.
[15] Aithal GP, Watkins PB, Andrade RJ.Case definition and phen-otype standardization in drug-induced liver injury[J]. Cinical Pharmacology & Therapeutics, 2011, 89(6): 806-815.
[16] Liu LW, Zhao XY, Jia JD.2019 European association for the study of the liver clinical practice guidelines: recommendations for drug-induced liver injury[J]. Chinese Journal of Hepatology(中华肝脏病杂志), 2019, 27(6): 420-423.
[17] Yu LC, Mao YM, Chen CW.Guidelines for diagnosis and treatment of drug-induced liver injury[J]. Journal of Practical Hepatology(实用肝脏病杂志), 2017, 20(2): 257-274.
[18] Regev A, Palmer M, Avigan MI, et al.Consensus:guidelines:best practices for detection, assessment and management of suspected acute drug-induced liver injury during clinical trials in patients with nonalcoholic steatohepatitis[J]. Alimentary Pharmacology and Therapeutics 2019, 49(6): 702-713.
[19] Nakatomi K, Nakamura Y, Tetsuya I, et al.Treatment with gefitinib after erlotinib-induced liver injury: a case report[J]. Journal of Medical Case Reports. 2011, 5(1): 593.
[20] Chen J, Zheng X, Liu DY, et al.Therapeutic effects and adverse drug reactions are affected by icotinib exposure and CYP2C19 and EGFR genotypes in Chinese non-small cell lung cancer patients[J]. Asian Pacific Journal of Cancer Prevention, 2014, 15(17): 7195-7200.
[21] Asai N, Ohkuni Y, Yamaguchi E, et al.Successful treatment of non-small cell lung cancer with gefitinib after erlotinib-induced severe eyelid erosion: two case reports[J]. Journal of Cancer Research and Therapeutics, 2015, 11(3): 653.

吉非替尼片致严重血清转氨酶升高伴急性胆囊炎1例分析

One Case of Severe Serum Transaminase Elevation with Acute Cholecystitis Induced by Gefitinib Tablets

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