PEMOLINE-ASSOCIATED FULMINANT LIVER-FAILURE - TESTING THE EVIDENCE FOR CAUSATION
PEMOLINE-ASSOCIATED FULMINANT LIVER-FAILURE - TESTING THE EVIDENCE FOR CAUSATION
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DOI：
10.1016/0009-9236(95)90233-3
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发表时间：
1995-06-01
影响因子：
6.7
通讯作者：
KOREN, G
中科院分区：
文献类型：
--
作者：
BERKOVITCH, M;POPE, E;KOREN, G
背景：匹莫林是一种中枢神经系统兴奋剂，用于治疗儿童注意缺陷多动障碍。肝毒性已被普遍报道与匹莫林，但是，只有两个报告的情况下，致命的肝衰竭已经published.Objectives：我们报告一个14岁的男孩谁收到了伴随匹莫林和哌醋甲酯，其中暴发性肝衰竭发生，肝移植失败。其他原因的暴发性肝衰竭被排除，肝活检提示药物毒性。我们估计的概率，这三种情况下，暴发性肝衰竭的风险增加与pemoline.Results：根据三个已知的致命的肝衰竭与pemolineuse.Results相关的情况下，我们计算出，接受pemoline的儿童有暴发性肝衰竭的发展的相对风险为45.3（95%的置信区间，4.1至510）。这种高度显著的相关性（p < 0.001）表明因果关系。结论：由于匹莫林近年来已被广泛使用，需要进一步的研究，以更好地量化这种风险在儿童注意缺陷多动障碍。
Background: Pemoline is a central nervous system stimulant used in treating children with attention deficit-hyperactivity disorder. Hepatotoxicity has been commonly reported in association with pemoline; however, only two reports of cases of fatal liver failure have been published.Objectives: We report on a 14-year-old boy who received concomitant pemoline and methylphenidate in whom fulminant liver failure occurred and for whom liver transplantation failed. Other causes of fulminant liver failure were ruled out, and the liver biopsy was suggestive of drug toxicity. We estimated the probability that these three cases represent an increased risk of fulminant liver failure associated with pemoline.Results: Based on the three known cases of fatal liver failure associated with pemoline use, we calculated that a child receiving pemoline has a relative risk of development of fulminant liver failure of 45.3 (95% confidence interval, 4.1 to 510). This highly significant association (p < 0.001) suggests causation.Conclusions: Because pemoline has been widely used in recent years, further studies are needed to better quantify this risk in children with attention deficit-hyperactivity disorder.