Anaphylactic shock and liver injury due to quadruple therapy for eradication of Helicobacter pylori infection
Department of Pharmacy, the First Hospital of Shanxi Medical University, Shanxi Province, Taiyuan 030001, China; Department of Critical Care Medicine, the First Hospital of Shanxi Medical University, Shanxi Province, Taiyuan 030001, China
Abstract：A 34-year-old female patient with Helicobacter pylori (Hp) infection received quadruple therapy for eradication of Hp infection, which contained esomeprazole, colloidal bismuth pectin, amoxicillin, and furazolidone. Before the treatment, the patient′s physical examination results were normal except the positive 14C urea breath test. On day 6 of medication, the patient developed fever, nausea, vomiting, and diarrhea, which returned to normal after drug withdrawal. About 20-minutes after taking furazolidone again 3 days later, the patient developed dizziness, amaurosis, vomiting, hand and foot convulsions with chills, unconsciousness, high fever, muscle soreness, fatigue, and generalized skin congestion with rash. Meanwhile her blood pressure was 76/34-mmHg. Laboratory tests showed alanine aminotransferase (ALT) 365-U/L and aspartate aminotransferase (AST) 596-U/L. Anaphylactic shock, and drug-induced liver injury were consi- dered. It was considered that the anaphylactic shock might be related to furazolidone, and liver injury might be related to esomeprazole, amoxicillin, and furazolidone. Symptomatic treatments such as blood pressure-raising, cooling, anti-allergy, and liver-protective drugs were given immediately. Ten days later, the above-mentioned symptoms disappeared completely, her body temperature was 36.3-℃, blood pressure was 126/75-mmHg, ALT was 59-U/L, and AST was 38-U/L.
李赟，李青，晋月萍，蔡月伟. 根除幽门螺杆菌四联疗法致过敏性休克和肝损伤[J]. 药物不良反应杂志, 2020, 22(8): 479-481.
Li Yun, Li Qing, Jin Yueping, Cai Yuewei. Anaphylactic shock and liver injury due to quadruple therapy for eradication of Helicobacter pylori infection. Adverse Drug Reactions Journal, 2020, 22(8): 479-481.
