Moses A, Zahger D, Amir G
Department of Internal Medicine, Hadassah University Hospital, Mt. Scopus, Jerusalem, Israel.
Digestion. 1989;42(1):57-60. doi: 10.1159/000199826.
We describe a 75-year-old patient who presented with severe cholestatic liver disease. He had been receiving methyldopa, 250 mg daily, for 6 years. An extensive evaluation failed to reveal extrahepatic obstruction or serologic evidence of viral hepatitis. A liver biopsy disclosed marked cholestasis, without hepatitis, and was compatible with a rare form of methyldopa-induced liver injury. Cessation of drug treatment was followed by a slow but complete recovery. Cholestasis is a rare manifestation of methyldopa hepatotoxicity. Although methyldopa-associated liver injury usually appears after about 4 weeks of treatment, a history of a much longer exposure does not exclude this entity.
我们描述了一位75岁患有严重胆汁淤积性肝病的患者。他每天服用250毫克甲基多巴，已持续6年。全面评估未能发现肝外梗阻或病毒性肝炎的血清学证据。肝活检显示有明显胆汁淤积，无肝炎表现，符合一种罕见的甲基多巴诱导的肝损伤形式。停药后病情缓慢但完全恢复。胆汁淤积是甲基多巴肝毒性的罕见表现。虽然甲基多巴相关的肝损伤通常在治疗约4周后出现，但更长时间的用药史并不能排除这种情况。
