After drinking cold medicine, the 27-year-old boy suffered severe liver damage!

It was just a common cold, but after taking cold medicine, 27-year-old Xiao Fang (pseudonym) accidentally suffered liver damage and was hospitalized for 11 days. The hospital finally helped him find the "suspect" through genetic testing.

I drank the cold medicine

Liver damage was found

A month ago, Xiao Fang, who worked in an IT company, felt unwell and weak, as if he had a common cold, so he went to the drugstore and bought some common cold medicine to take home.

He drank Ganmao Ling for one day, and then drank Xiao Chaihu on the second day. But a new problem came. A rash suddenly appeared on Xiao Fang's thigh. It was not very dense, but it persisted.

Xiao Fang went to the fever clinic of Shenzhen University General Hospital to have a blood test. The white blood cell and neutrophil counts were both elevated, indicating infection or inflammatory response. So the doctor prescribed acetaminophen tablets, cefaclor and Pueraria lobata oral solution as a cold treatment, and also told Xiao Fang to keep an eye on it at all times.

Two days later, the rash spread to his waist and he felt pain in his waist. Xiao Fang remembered that when he was in the fever clinic, the nurse reminded him that his eyes were a little yellow.

Is the liver damaged? Xiao Fang was worried, so he went to see a doctor at the hepatobiliary surgery department.

The doctor who received the patient, Yin Zongyi, prescribed a series of tests and laboratory tests. Sure enough, the liver function test results showed that the important indicators reflecting the liver's synthetic function, liver excretion function and serum enzyme levels were several times higher than the upper limit of the normal range. In particular, the total bilirubin level was nearly 10 times higher, indicating that the liver was seriously damaged. If it is not treated quickly, the liver function may continue to deteriorate, and then hemodialysis or even liver transplantation will be required.

Fortunately, the color Doppler ultrasound and CT scans showed no obvious abnormalities. Considering Xiaofang's medical history, Yin Zongyi judged that Xiaofang was most likely suffering from drug-induced liver injury, and immediately admitted him to the inpatient department, where he began a series of liver protection and choleretic treatments.

After 11 days in hospital, Xiaofang's liver function indexes steadily decreased, his jaundice was cured, his rash subsided, and he was discharged smoothly. The doctor asked him to continue taking medication to consolidate the treatment, and he was re-examined a week later, and the indexes were close to normal.

Allergic to medication?

Gene mutations to blame

Xiao Fang and his family found it a bit "unbelievable" that a minor cold and a few cups of ordinary cold medicine could cause such serious consequences.

In order to investigate the cause, Li Xiaowu, director of the Department of Hepatobiliary Surgery, invited pharmacists from the Department of Pharmacy to participate in the consultation. Pharmacist Liao suggested that Chinese patent medicines may cause liver damage. For example, volatile oil of Bupleurum has hepatotoxic components. Cold medicines containing acetaminophen may also cause liver failure, but most of them occur in cases of overdose.

According to Xiao Fang's recollection, he took the cold medicine and tablets one after another, and neither dose exceeded the recommended amount.

Finally, the consultation opinion was to have Xiaofang undergo a genetic test to see if there were any genes that could cause adverse drug reactions. This time, there was indeed new evidence, the HLA-B*5801 allele was positive.

Studies have found that patients carrying specific genetic genes may have a higher chance of adverse reactions to certain drugs than other people by tens or even thousands of times. The HLA-B*5801 allele located on human chromosome 6 is one of them. This genotype is significantly associated with severe skin adverse reactions caused by allopurinol (commonly used to treat gout). The HLA-B*5801 carrier rate in the Han Chinese is 8.8%-10.9%.

In addition, studies have also shown that adverse reactions caused by acetaminophen (APAP) are closely related to the HLA gene.

This discovery reminded Xiao Fang that since he had this gene, he had to be more cautious when taking medicine in the future.

Itchy skin after taking medicine

Be careful when you have a rash on your body

According to doctors, everyone is at risk of allergies when taking any medication. Drug allergies have a latent period, usually 4 to 28 days, and hypersensitive people may develop symptoms within a few hours of taking the medication. Some drugs have a long incubation period, and rashes may not appear until 1-2 months after taking the medication.

Pay attention to changes in your body after taking medicine. After an allergic reaction occurs, there will be three symptoms that can be seen, touched, and felt.

Rash, itching, high fever:

Skin rash is the most common drug allergic reaction to most drugs. The time it takes for a drug to be metabolized in the body is different, and the time when the rash appears will also be different. Once you have red spots, rashes, itchy and red skin, or a fever, you must see a doctor as soon as possible and tell the doctor clearly what drugs you have used recently. This can help the doctor determine the condition and develop a treatment plan.

Shortness of breath, decreased blood pressure, fainting:

This type of allergic reaction symptoms usually appear a few minutes after the injection of intravenous drugs such as penicillin. Once it occurs, emergency treatment is required immediately.

Redness, swelling and numbness of mouth, tongue and face:

Such an allergic reaction may occur when taking antihypertensive drugs such as angiotensin-converting enzyme inhibitors (ACE inhibitors) such as pril.

Generally speaking, less serious drug allergic reactions will improve quickly after stopping the medication.

(Source: Guangzhou Daily)