Barbare J C, Latrive J P, Kaloustian E, Broquie G, Legendre C, Poupon R
Service d'Hépato-gastroentérologie, Centre Hospitalier, Compiègne.
Gastroenterol Clin Biol. 1988 Jan;12(1):71-3.
The authors report the cases of 3 women who developed hepatic injury during administration of metapramine, a tricyclic antidepressant introduced in France in 1984. One patient had jaundice and pruritus; the 2 others had loss of weight. Serum alkaline phosphatase and serum transaminase activities were increased in 3 and 2 patients, respectively. Blood hypereosinophilia was found in one patient; erythrocyte sedimentation rate was elevated in 2 patients. The outcome was favorable after drug withdrawal in the 3 patients. Liver biopsy showed centrolobular cholestasis in the 3 patients. There was no rechallenge; in 2 patients, other drugs than metapramine might be implicated in hepatic injury; however, the similarity of these 3 cases suggests that metapramine, like other tricyclic antidepressants, may be responsible for hepatic injury.
作者报告了3名女性在服用三甲丙咪嗪（一种1984年在法国上市的三环类抗抑郁药）期间出现肝损伤的病例。1例患者出现黄疸和瘙痒；另外2例出现体重减轻。3例患者血清碱性磷酸酶活性升高，2例患者血清转氨酶活性升高。1例患者出现血液嗜酸性粒细胞增多；2例患者红细胞沉降率升高。3例患者停药后预后良好。肝活检显示3例患者均有小叶中心性胆汁淤积。未进行再次用药挑战；2例患者的肝损伤可能与三甲丙咪嗪以外的其他药物有关；然而，这3例病例的相似性表明，三甲丙咪嗪与其他三环类抗抑郁药一样，可能是肝损伤的原因。
