Jain D, Bowlus C L, Anderson J M, Robert M E
Department of Pathology, Yale University School of Medicine, New Haven, Connecticut 06520-8023, USA.
J Clin Gastroenterol. 2000 Oct;31(3):241-3. doi: 10.1097/00004836-200010000-00012.
Hepatotoxicity due to chronic amiodarone (AD) use is well described. However, hepatitis occurring after acute administration of AD has only occasionally been reported and the pathologic findings in the liver in this condition have not been well characterized. We describe an idiosyncratic reaction, in a 40-year-old man after 6 weeks of oral AD therapy, consisting of acute hepatitis, which resolved after withdrawal of the drug. The liver biopsy showed clusters of cells with granular cytoplasm. These cells were characterized as macrophages, and phospholipid membranous inclusions were demonstrated ultrastructurally in the granular cells and in the hepatocytes. Pathologists and clinicians should be aware of this subtle histologic finding when looking for evidence to support AD hepatotoxicity.
长期使用胺碘酮（AD）导致的肝毒性已有充分描述。然而，急性服用AD后发生肝炎的情况仅有偶尔报道，且这种情况下肝脏的病理表现尚未得到充分表征。我们描述了一名40岁男性在口服AD治疗6周后出现的一种特异质性反应，表现为急性肝炎，停药后病情缓解。肝活检显示有细胞质呈颗粒状的细胞簇。这些细胞被鉴定为巨噬细胞，超微结构显示颗粒细胞和肝细胞中有磷脂膜性包涵体。病理学家和临床医生在寻找支持AD肝毒性的证据时应注意这一细微的组织学发现。
