Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UNIPROT:P17174 (aspartate aminotransferase)
 14,872 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sea-urchin stings may produce injurious and venomous wounds. Although numerous writers refer to the danger of pedicellarial stings, there is little worth-while clinical data. We report a case of sea-urchin injury with severe local reaction and acute hepatitis. A 47-y-o Taiwanese woman accidentally stepped on a sea urchin while scuba diving on a beach in Palau Islands. The puncture wounds were numerous and she felt faintness, and immediate and intense pain. Initial management included partial spine removal, betadine immersion, intravenous fluid and analgesics. She developed fever, chills, nausea, and persistent serous discharge and tenderness from the sites of stings in the following days. She was admitted due to right foot cellulitis, sea-urchin injuries of both soles and suspected toxic hepatitis on the 7th day after envenomation. Serum alanine transaminase was 810 U/L and aspartate transaminase 320 U/L; she received i.v. antibiotics and wound debridement for removal of residual stings. She recovered gradually and was discharged 2 w later. Travel related marine animal injury has an increasing tendency throughout the world. This case had the unusual presentation of severe local reaction and hepatitis; immediate and more aggressive spine removal might have lessened the degree of injury.
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PMID:Sea-urchin envenomation. 1464 Apr 80

BACKGROUND Drug-induced liver injury (DILI) can present clinically as a spectrum that includes asymptomatic elevation of transaminases, acute or chronic hepatitis, and acute liver failure. Idiosyncratic DILI is more likely to affect individuals with comorbidities, and to have a wide range of clinical presentations. Although antibiotics are associated with DILI, the fluoroquinolone, ciprofloxacin, is a rarely reported cause. Two cases of idiosyncratic DILI following ciprofloxacin treatment are described, including a review of the literature. CASE REPORT Case 1: A 35-year-old man was treated with ciprofloxacin for periorbital cellulitis. On the second day of ciprofloxacin treatment, he developed abdominal pain, nausea, vomiting and increased serum levels of liver transaminases, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Further investigations excluded infectious hepatitis, autoimmune disease, or structural liver disease. Exclusion of other causes of DILI and cessation of ciprofloxacin resulted in clinical improvement and normalization of liver function tests (LFTs). Case 2: An 82-year-old man was treated with ciprofloxacin for osteomyelitis. On the tenth day of ciprofloxacin treatment, he developed jaundice and abnormal LFTs, including increased AST, ALT, alkaline phosphatase (ALP), and total bilirubin. Further investigations excluded infectious hepatitis, autoimmune disease, or structural liver disease. Exclusion of other causes of DILI and cessation of ciprofloxacin resulted in clinical improvement and normalization of LFTs. CONCLUSIONS Idiosyncratic DILI due to ciprofloxacin treatment is rare. These two cases have shown that timely diagnosis and discontinuation of ciprofloxacin can prevent the progression of DILI, reduce liver damage, and reduce mortality rates from DILI.
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PMID:Idiosyncratic Drug-Induced Liver Injury Due to Ciprofloxacin: A Report of Two Cases and Review of the Literature. 3026 95