Lindner H, du Bosque G, Dammermann R, Klöppel G, Krause D
Dtsch Med Wochenschr. 1975 Dec 5;100(49):2530-5. doi: 10.1055/s-0028-1106580.
Over a period of 18 months the development of hepatitis after intake of oxyphenisatin, a laxative, was established in 14 patients by re-exposure to the drug. The characteristic feature was nonspecific upper abdominal pain up to colic-like pain, lact of appetite, nausea or vomiting, and pruritus. The biochemical changes were those of chronic hepatitis with varying severity of biliary stasis and abnormal immunofluorescence. On re-exposure there was a particularly remarkable rise in GLDH activity. The histological picture showed acute inflammatory changes in the biliary passages on re-exposure, while the liver cells were clearly involved only secondarily. At a latter point the histological picture became non-specific. At laparoscopy there were different stages of minor periportal hepatic fibrosis to marked postnecrotic liver scars with portal hypertension and decompensation. Early diagnosis is difficult but crucial to the patient's fate, because this form of hepatitis regresses completely after oxyphenisatin has been stopped. Laxatives containing this drug should be withdrawn from the market.
在18个月的时间里,通过再次接触一种名为奥昔芬汀的泻药,确定了14名患者在服用该泻药后出现肝炎。其特征表现为程度不一的上腹部疼痛,直至绞痛样疼痛、食欲不振、恶心或呕吐以及瘙痒。生化变化表现为慢性肝炎,伴有不同程度的胆汁淤积和异常免疫荧光。再次接触该药物时,谷氨酸脱氢酶(GLDH)活性显著升高。组织学图像显示,再次接触时胆管出现急性炎症变化,而肝细胞明显只是继发性受累。在后期,组织学图像变得不具特异性。腹腔镜检查显示存在不同阶段的轻度门静脉周围肝纤维化,直至伴有门静脉高压和失代偿的明显坏死性肝瘢痕。早期诊断困难,但对患者的命运至关重要,因为这种肝炎在停用奥昔芬汀后会完全消退。含该药物的泻药应退出市场。