Case report of acute liver injury caused by the eszopiclone in a patient with chronic liver disease
Autor: | Ge Yu, Zhaoxia Li, Guijie Xin, Tong Wu |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Hepatitis B virus trazodone medicine.drug_class CYP450 Chronic liver disease Gastroenterology Piperazines Hypnotic 03 medical and health sciences 0302 clinical medicine Hepatitis B Chronic Liver Function Tests Internal medicine Sleep Initiation and Maintenance Disorders medicine case report Humans 030212 general & internal medicine Clinical Case Report Zopiclone Hepatitis eszopiclone medicine.diagnostic_test Eszopiclone business.industry chronic liver disease General Medicine Hepatitis B Middle Aged medicine.disease Liver 030220 oncology & carcinogenesis Liver biopsy Female Chemical and Drug Induced Liver Injury business Liver function tests drug-induced liver injury Azabicyclo Compounds medicine.drug Research Article |
Zdroj: | Medicine |
ISSN: | 1536-5964 0025-7974 |
Popis: | Rationale: Eszopiclone, sold under the brand name Lunesta, is a new type of non-benzodiazepine hypnotic. Eszopiclone is a zopiclone dextrorotation, which is classified as a cyclopyrrolone. It functions by binding gamma-aminobutyric acid (GABA) receptors. Compared with benzodiazepines hypnotics, eszopiclone has higher selectivity for certain subunits of the GABA(A) receptor. So far, there are no reports about the elevation of serum enzymes or severe liver injury caused by eszopiclone. Here, we present a case report of acute liver injury following eszopiclone treatment in a patient with chronic hepatitis B virus (HBV). Patient concerns: The patient was a 53-year-old female with a 36-year history of positive HBV markers. Due to poor sleep, the patient took trazodone hydrochloride orally for 1 year. After hospital admission for positive hepatitis B pathogenic markers, abdominal distension, fatigue, and aggravation, she was treated with eszopiclone under the guidance of the mental health department. Diagnoses: Her transaminase levels increased abnormally after eszopiclone treatment and rapidly decreased after drug withdrawal. This was determined to be an acute liver injury event. liver-protecting treatment was maintained. Considering the patient's anxiety and depression, the patient's family members refused a liver biopsy. Outcomes: Transaminase levels decreased rapidly within one week, and the patient continued to take trazodone hydrochloride after discharge. No adverse events occurred in the follow-up period. Lessons: Sleep disorders are more common in patients with chronic diseases, especially patients with chronic liver disease. Recently, it has become common for patients with hepatitis B and C to use antidepressants along with antiviral treatment. Patients with chronic hepatitis B or C may have a threefold risk of liver dysfunction after receiving antituberculosis treatment.[1,2] A proinflammatory environment induced by actively replicating the hepatitis virus may alter the detoxication process and increase drug toxicity.[3] At this time, the safety of other drugs should be reevaluated. Although hepatitis and liver injury are listed as rare adverse reactions of eszopiclone, this case is the first to report the eszopiclone-involved acute liver injury. |
Databáze: | OpenAIRE |
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