Guharoy S R, Shahin J, Levin S
John F Kennedy Memorial Hospital, Indio, CA 92201.
Vet Hum Toxicol. 1991 Dec;33(6):613-4.
Although quinidine has been widely used since the beginning of the century, quinidine-induced hepatotoxicity has been recently reported in the literature. We describe a reversible case of quinidine-induced hepatotoxicity. A 62-y-old male with a past medical history of atrial flutter and adult onset diabetes was admitted to the hospital with a 3-d history of diarrhea, nausea, fever, chills and palpitations. Past medications included 7.5 mg glyburide daily for 4 y, 0.25 mg digoxin daily for 3 w, 324 mg quinidine gluconate 3 times daily for 2 w, and 150 mg papaverine daily for 2 y. On admission, liver enzyme levels were elevated (SGOT 606, SGPT 1104). Quinidine was considered an etiologic agent and was discontinued after administration of 1 dose. The patient became afebrile within 48 h, liver enzyme levels gradually decreased, and the patient was discharged on day 6 of hospitalization. Repeat enzyme levels obtained 12 d after discharge were mostly within normal limits. The symptoms were atypical as described in the literature. We conclude that unexplained fever or elevated liver enzyme levels should alert the clinician to the possibility of quinidine-induced hepatotoxicity.
尽管自本世纪初以来奎尼丁就已被广泛使用，但最近文献报道了奎尼丁诱发的肝毒性。我们描述了一例奎尼丁诱发肝毒性的可逆病例。一名62岁男性，有房扑和成年发病型糖尿病病史，因腹泻、恶心、发热、寒战和心悸3天入院。既往用药包括每日7.5毫克格列本脲，共4年；每日0.25毫克地高辛，共3周；每日3次324毫克葡萄糖酸奎尼丁，共2周；每日150毫克罂粟碱，共2年。入院时，肝酶水平升高（谷草转氨酶606，谷丙转氨酶1104）。奎尼丁被认为是病因，在服用1剂后停药。患者在48小时内退热，肝酶水平逐渐下降，患者在住院第6天出院。出院12天后复查的酶水平大多在正常范围内。症状与文献中描述的不典型。我们得出结论，不明原因的发热或肝酶水平升高应提醒临床医生注意奎尼丁诱发肝毒性的可能性。
