Islam S, Mekhloufi F, Paul J M, Islam M, Johanet C, Legendre C, Degott C, Abuaf N, Homberg J C
Laboratoire Central d'Immunologie et d'Hématologie Hôpital Saint-Antoine, Paris.
Autoimmunity. 1989;2(3):213-21. doi: 10.3109/08916938909014685.
The clinical, biochemical, histopathological and immunological features of 30 cases of clometacin-induced hepatitis are described. The age range of the patients was 32-84 years with a notable female predominance of 29:1. The hepatitis was highly cytolytic with high values of transaminases but with little or no cholestasis. Gammaglobulins were higher than 18 g/l in 73% of the cases. 25 liver biopsies were performed and showed acute hepatitis with a predominant centrilobular necrosis in 17; chronic aggressive hepatitis was noted in 8 cases but 1 showed concomitant cirrhotic changes. Anti-tissue antibodies were looked for in all cases. Anti-smooth muscle antibodies of anti-actin cable type (titre 1/80 to 1/2, 560) were detected in 19 cases, anti-nucleus antibodies in 16 cases which were associated to the former in 14 cases. The above findings show that clometacin produces a hepatitis syndrome quite akin to autoimmune chronic active hepatitis (lupoid hepatitis) and to the hepatopathy induced by oxyphenisatin.
本文描述了30例氯美辛所致肝炎的临床、生化、组织病理学及免疫学特征。患者年龄范围为32 - 84岁，女性明显居多，男女比例为29:1。肝炎具有高度细胞溶解性，转氨酶值高，但胆汁淤积很少或无胆汁淤积。73%的病例中γ球蛋白高于18g/L。进行了25例肝脏活检，其中17例显示为急性肝炎，以小叶中心性坏死为主；8例为慢性侵袭性肝炎，但1例伴有肝硬化改变。所有病例均检测了抗组织抗体。19例检测到抗肌动蛋白丝束型抗平滑肌抗体（滴度为1/80至1/2560），16例检测到抗核抗体，其中14例与前者相关。上述结果表明，氯美辛可引发一种肝炎综合征，与自身免疫性慢性活动性肝炎（狼疮样肝炎）及奥昔酚汀所致肝病颇为相似。
