摘要
铂类化疗药物导致的药物性肝损伤(DILI)大多以转氨酶升高为主要临床表现,以血管损伤为临床表现者相对少见,文献报道铂类药物引起血管损伤的DILI以肝窦阻塞综合征为表现的较为常见,少见导致门静脉肝窦血管性疾病(PSVD)的报道。该文报道铂类化疗药物诱发PSVD 1例,临床以门脉高压为突出表现,而肝功能正常或接近正常,肝功能受损与门静脉高压程度不平行,经影像学排除肝外血管性疾病,虽然影像学提示有肝硬化,但肝脏瞬时弹性成像检测不支持肝硬化,肝穿刺活检组织病理学也排除肝硬化,且具有PSVD的特征性组织病理表现,随访1年,患者目前病情相对稳定。
Drug-induced liver injury(DILI)caused by platinum-based chemotherapy drugs is characterized by elevated aminotransferase,while vascular injury is relatively rare as a special clinical phenotype of DILI.It has been reported that DILI caused by platinum-based chemotherapy drugs is more common with hepatic sinus obstruction syndrome,while porto-sinusoidal vascular disorder(PSVD)caused by platinum-based chemotherapy drugs is rarely reported.This report describes a case with prominent clinical manifestations of portal hypertension and normal or nearly normal liver function.Liver function impairment and portal hypertension were not parallel.Extrahepatic vascular diseases were excluded by imaging.Although imaging suggested cirrhosis,liver transient elastography(TE)did not support cirrhosis,and liver biopsy histopathology also excluded cirrhosis,revealing characteristic histopathological features of PSVD.The patient was diagnosed with PSVD induced by platinum-based chemotherapy drugs.After one year of follow-up,the patient's condition remained relatively stable.
作者
何承志
夏璐
王喆
杨长青
HE Cheng-zhi;XIA Lu;WANG Zhe;YANG Chang-qing(Department of Gastroenterology,Institute of Digestive Diseases,Tongji Hospital Affiliated to Tongji University(Shanghai,200065),China.)
出处
《中西医结合肝病杂志》
2025年第4期402-405,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
关键词
门脉高压
食管胃底静脉曲张
肝脏血管性疾病
门脉肝窦血管病
portal hypertension
esophageal and gastric varices
vascular disease of the liver
portal-sinusoidal vascular disorder
