Koch M J, Seeff L B, Crumley C E, Rabin L, Burns W A
Gastroenterology. 1976 Jun;70(6):1136-40.
A case is described of presumed quinidine hepatotoxicity, characterized by the development of fever, abnormal serum transaminase values, which improved after cessation of the drug but recurred after a challenge dose, and centrizonal hepatocellular necrosis detected on liver biopsy. Morphological changes on electron microscopy, consistent with a drug reaction, are also described. Pertinent features of previous case reports are analyzed, and the histological findings by light microscopy of the present and past cases are discussed. It is suggested that the development of unexplained fever within 1 month of quinidine administration should lead to consideration of possible hepatotoxicity.
本文描述了一例疑似奎尼丁肝毒性的病例，其特征为发热、血清转氨酶值异常，停药后病情改善，但再次给予激发剂量后复发，肝活检发现中央区肝细胞坏死。还描述了电子显微镜下与药物反应一致的形态学变化。分析了既往病例报告的相关特征，并讨论了本病例和既往病例的光镜组织学发现。建议在服用奎尼丁1个月内出现不明原因发热时应考虑可能的肝毒性。
