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[一例由胺碘酮引起的胆汁淤积性肝炎病例]

[A case of cholestatic hepatitis caused by amiodarone].

作者信息

Salti Z, Cloche P, Weber P, Houssemand G, Vollmer F

机构信息

Service de Médecine B, CHG, Remiremont.

出版信息

Ann Cardiol Angeiol (Paris). 1989 Jan;38(1):13-6.

PMID:2648965
Abstract

The authors report the case of a 70 year old male patient, who was treated with amiodarone for 9 months (200 mg/d-5 days/7) for alcohol-induced hypokinetic cardiomyopathy, complicated by ventricular dysrhythmia and hospitalized for jaundice, pruritus, and deterioration of his general condition. Alkaline phosphatases were elevated significantly (7 times the upper limit for normal) with a moderate rise in serum transaminases twice the upper limit for normal). Ultrasound of the liver and biliary tract was normal. There were no serum markers for hepatitis B virus. No anti-tissue antibodies were found. A liver biopsy revealed portal and septal fibrosis, and polymorphous inflammatory infiltration with a majority of polymorphonuclear neutrophils and Mallory bodies. Intracellular and intralysosomal phospholipid inclusions were observed with electron microscopy. Clinical and laboratory test value outcome was favorable two weeks after cessation of administration of amiodarone.

摘要

作者报告了一例70岁男性患者,该患者因酒精性运动减退型心肌病接受胺碘酮治疗9个月(200mg/d,每周5天),并发室性心律失常,因黄疸、瘙痒及全身状况恶化而住院。碱性磷酸酶显著升高(为正常上限的7倍),血清转氨酶中度升高(为正常上限的2倍)。肝脏和胆道超声检查正常。未检测到乙肝病毒血清标志物。未发现抗组织抗体。肝活检显示门脉和间隔纤维化,以及多形性炎症浸润,主要为多形核中性粒细胞和马洛里小体。电子显微镜下观察到细胞内和溶酶体内磷脂包涵体。停用胺碘酮两周后,临床和实验室检查值结果良好。

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