de Man R A, Wilson J H, Schalm S W, ten Kate F J, van Leer E
Department of Internal Medicine, University Hospital Dijkzigt, Rotterdam, The Netherlands.
J Hepatol. 1990 Nov;11(3):318-21. doi: 10.1016/0168-8278(90)90214-c.
A 58-year-old man presented with jaundice 6 months after aortic valve replacement. Although non-A, non-B hepatitis was initially suspected, the final diagnosis of phenprocoumon (Marcoumar)-induced hepatitis progressing to cirrhosis was based on recurrence of jaundice after re-exposure to the drug, improvement after withdrawal and centrilobular necrosis with eosinophilic infiltration in the liver biopsy. Antibodies to hepatitis C virus were absent. The aortic valve was replaced by a bioprosthesis to eliminate the need for life-long anticoagulation.
一名58岁男性在主动脉瓣置换术后6个月出现黄疸。尽管最初怀疑是非甲非乙型肝炎，但最终诊断为苯丙香豆素（Marcoumar）所致肝炎并进展为肝硬化，依据是再次接触该药物后黄疸复发、停药后病情改善以及肝活检显示小叶中心坏死伴嗜酸性粒细胞浸润。未检测到丙型肝炎病毒抗体。主动脉瓣被生物假体置换，以消除终身抗凝的必要性。
