Olmos M, Guma C, Colombato L O, Lami G, Miyashiro R, Alvarez E
Hospital Nacional Alejandro Posadas, Haedo, Provincia de Buenos Aires.
Acta Gastroenterol Latinoam. 1987;17(2):105-11.
Two thousand six hundred and seventy one liver biopsies were reviewed from 1972 to 1985 at the Hospital A. Posadas. There were 26 patients with drug-induced liver injury; those who fulfilled the following criteria were included: contact with a drug known to produce hepatotoxicity; clinic, biologic and histologic picture corresponding to the drug studied, complete recovery after the drug was stopped and no other hepatic toxics. Fourteen patients showed estrogen-induced intrahepatic cholestasis, 5 had hepatitis-like lesions due to: alphamethyldopa (3), ketoconazole (1) and indomethacin (1). Carbon tetrachloride caused fatty degeneration in two patients and phenylbutazone a granulomatous hepatitis in one patient and cholestatic hepatitis in other. The last three cases were cholestatic lesions after the administration of chlorpromazine allopurinol and penicillin respectively. The evolution in 24 patients was excellent after the drug was withdrawn. Two patients died because of surgical complications since they were operated on with the wrong diagnosis of extrahepatic cholestasis.
1972年至1985年期间，对阿波斯达斯医院A的2671份肝活检样本进行了回顾性研究。其中有26例药物性肝损伤患者；符合以下标准的患者被纳入研究：接触过已知可产生肝毒性的药物；临床、生物学和组织学表现与所研究药物相符，停药后完全康复且无其他肝毒性物质。14例患者表现为雌激素诱导的肝内胆汁淤积，5例患者出现肝炎样病变，病因分别为：α-甲基多巴（3例）、酮康唑（1例）和吲哚美辛（1例）。四氯化碳导致2例患者出现脂肪变性，保泰松导致1例患者出现肉芽肿性肝炎，另1例患者出现胆汁淤积性肝炎。最后3例分别是在使用氯丙嗪、别嘌醇和青霉素后出现的胆汁淤积性病变。停药后，24例患者的病情转归良好。2例患者因手术并发症死亡，因为他们被误诊为肝外胆汁淤积而接受了手术。
