Lactic acidosis and hepatic steatosis associated with use of stavudine: Report of four cases
Lactic acidosis and hepatic steatosis associated with use of stavudine: Report of four cases
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DOI：
10.7326/0003-4819-133-3-200008010-00010
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发表时间：
2000-08-01
影响因子：
39.2
通讯作者：
Kovacs, JA
中科院分区：
文献类型：
--
作者：
Miller, KD;Cameron, M;Kovacs, JA
背景：报道了一种罕见但危及生命的肝脂变、乳酸酸中毒和肌病综合征与使用齐多夫定和二磷酸核苷之间的关系。目的：描述服用司他夫定的四名患者的肝脏脂肪变性、乳酸酸中毒和肌病综合征。设计：病例系列。背景：华盛顿特区的一家社区医院和马里兰贝塞斯达的美国国立卫生研究院临床中心。患者：两男两女，服用司他夫定后出现乳酸酸中毒和转氨酶水平升高。所有患者均需加强护理。检测：乳酸、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、淀粉酶和脂肪酶水平；腹部计算机断层扫描；肝脏活检(2例)；肌肉活检(2例)。结果：与线粒体损伤相一致的组织学结果证实了肝脏或肌肉异常的诊断。结论：由于肝脏脂肪变性可能危及生命，医生应考虑这可能是服用司他夫定患者肝脏转氨酶水平升高的可能原因。
Background: An association between use of zidovudine and didanosine and a rare but life-threatening syndrome of hepatic steatosis, lactic acidosis, and myopathy has been reported.Objective: To describe the syndrome of hepatic steatosis, lactic acidosis, and myopathy in four patients taking stavudine.Design: Case series.Setting: A community hospital in Washington, D.C., and National Institutes of Health Clinical Center, Bethesda, Maryland.Patients: Two men and two women with HIV-1 infection who were taking stavudine presented with lactic acidosis and elevated levels of aminotransferases. All patients required intensive care.Measurements: Levels of lactic acid, alanine aminotransferase, aspartate aminotransferase, amylase, and lipase; computed tomography of the abdomen; liver biopsy (two patients); and muscle biopsy (two patients).Results: Histologic findings consistent with mitochondrial injury confirmed the diagnosis of hepatic or muscle abnormality.Conclusion: Because hepatic steatosis may be life-threatening, physicians should consider it as a possible cause of elevated hepatic aminotransferase levels among patients taking stavudine.