Federmann G, Becker E W, Tautorat H, Penschuck C, Berg P A
Kreiskrankenhaus Goslar, Chirurgische Abteilung, Medizinische Universitätsklinik Tübingen.
Dtsch Med Wochenschr. 1988 Oct 28;113(43):1676-9. doi: 10.1055/s-2008-1067871.
After accidental re-exposure to metamizole a 50-year-old patient developed severe jaundice within five hours (total bilirubin 43.9 mg/dl) with a rise of GOT to 147, of GPT to 222, of gamma-GT to 380 and of alkaline phosphatase to 497 U/l. The allergic genesis of this reaction was demonstrated in the lymphocyte transformation test which, in the presence of the causative substance and its metabolites, was performed five times during a period of 232 days. The first three tests were positive with stimulation indices up to 2.3. Sensitization to the metabolite 4-aminoantipyrine was demonstrated: this is known to be the first of four metabolites formed within 1-1 1/2 hours and constituting 40% of the four metabolites in the blood.
一名50岁患者意外再次接触安乃近后，在五小时内出现严重黄疸（总胆红素43.9mg/dl），谷草转氨酶升至147，谷丙转氨酶升至222，γ-谷氨酰转肽酶升至380，碱性磷酸酶升至497U/l。淋巴细胞转化试验证实了该反应的过敏起源，在232天内，在致病物质及其代谢产物存在的情况下，该试验进行了五次。前三次试验呈阳性，刺激指数高达2.3。证实了对代谢产物4-氨基安替比林的致敏：已知它是在1-1.5小时内形成的四种代谢产物中的第一种，占血液中四种代谢产物的40%。
