Wollheim F A, Lindström C G
Scand J Rheumatol Suppl. 1979(28):100-7. doi: 10.3109/03009747909108248.
Liver enzymes were followed in 99 patients treated with D-penicillamine for rheumatoid arthritis. In six abnormalities were found which consisted of elevated levels of lactic dehydrogenase. ALAT/ASAT, alkaline phosphatases or combinations of these. The changes were reversible on stopping the drug with one possible exception. No evidence of biliary cirrhosis, chronic active hepatitis or HBag-associated hepatitis was found. Liver biopsy was performed in 4 cases--one was taken 2 months after the treatment was discontinued, and was normal. One biopsy showed mild inflammatory changes, whereas in two histologic evidence of toxic liver necrosis was present. Liver damage should be included among possible complications of D-PA treatment.
对99例接受青霉胺治疗类风湿性关节炎的患者进行了肝脏酶的监测。发现6例出现异常，表现为乳酸脱氢酶、谷丙转氨酶/谷草转氨酶、碱性磷酸酶水平升高或这些指标的组合升高。停药后这些变化是可逆的，可能有一个例外。未发现胆汁性肝硬化、慢性活动性肝炎或乙肝相关肝炎的证据。对4例患者进行了肝活检——1例在停药2个月后进行，结果正常。1例活检显示轻度炎症改变，而另外2例有中毒性肝坏死的组织学证据。肝损伤应被纳入青霉胺治疗可能的并发症之中。
