Omata Fumio, Shibata Minoru, Nakano Masayuki, Jacobs Joshua L, Tokuda Yasuharu, Fukutake Katsuhide, Takahashi Osamu, Fukui Tsuguya
Gastroenterology Center, St Luke's International Hospital, Tokyo.
Intern Med. 2009;48(22):1945-9. doi: 10.2169/internalmedicine.48.2505. Epub 2009 Nov 16.
A 49-year-old asthmatic woman with a history of drug allergy to aspirin and penicillin presented to the hospital with fever, dark urine, general exanthema and fatigue. Physical examination revealed jaundice. She had been taking four different over-the-counter drugs. Laboratory examination showed eosinophilia, elevated Ig E, hyperbilirubinemia and elevated liver function tests. HBs Ag, anti-HCV Ab and Ig M anti-HA were negative. She was initially diagnosed with drug-induced hepatitis and was treated with steroids. However, liver dysfunction with eosinophilia relapsed after discontinuing steroids. Liver biopsy revealed eosinophilic infiltration. Steroids were discontinued after the start of 6-mercaptopurine.