Severe liver injury and acute renal failure induced by ibuprofen
10.3760/cma.j.cn114015-20201111-01126
- VernacularTitle:布洛芬致重度肝损伤和急性肾衰竭
- Author:
Qin LI
1
;
Ga ZHUO
;
Meiling JIN
;
Xiaofen YE
Author Information
1. 复旦大学附属中山医院药剂科，上海 200032
- Publication Type:Journal Article
- Keywords:
Ibuprofen;
Chemical and drug induced liver injury;
Renal insufficiency
- From:
Adverse Drug Reactions Journal
2021;23(6):317-318
- CountryChina
- Language:Chinese
-
Abstract:
A 40-year-old female patient took ibuprofen dispersible tablets twice (0.4 g, 3-4 hours interval) by herself due to fever. One hour after the second medication, the patient developed nausea, vomiting, and small bleeding spots on skin. One day later, she developed yellowish skin and sclera. Three days later, her urine output decreased to 300-400 ml daily. Five days later, laboratory tests showed alanine aminotransferase (ALT) 3 531 U/L, aspartate aminotransferase (AST) 811 U/L, total bilirubin (TBil) 149.7 μmol/L, creatinine (Scr) 753 μmol/L, and uric acid (UA) 800 μmol/L. She was diagnosis as having severe liver injury and acute renal failure, which was considered to be associated with ibuprofen. After 6 days of treatments such as liver protection, continuous renal replacement therapy (CRRT), and fresh frozen plasma infusion, the patient′s yellowish skin and sclera were relieved and small bleeding points reduced. Laboratory tests showed ALT 513 U/L, AST 36 U/L, TBil 31.5 μmol/L, Scr 281 μmol/L, and UA 241 μmol/L. Her urine volume was 2 500 ml per day. After CRRT was stopped and liver-protective treatment was continued for 14 days, the yellowish skin subsided and the bleeding points disappeared. Laboratory tests showed ALT 55 U/L, AST 39 U/L, TBil 15.6 μmol/L, Scr 101 μmol/L, and UA 237 μmol/L, and her urine volume was 4 000 ml per day.
