Kummer H, Marti F, Wegmann W
Schweiz Med Wochenschr. 1985 Nov 23;115(47):1674-8.
Four patients are described who developed granulomatous hepatitis 4-6 weeks after treatment with nomifensin. The granulomas were located both in the portal tract and the liver parenchyma, and contained eosinophils and a few polynuclear giant cells. Serum alkaline phosphatase, alanine aminotransferase and bilirubin were raised in three, two and one patient respectively. After medication was discontinued all abnormalities disappeared within 6-10 weeks. After oral intake of 25-50 mg nomifensin all patients experienced paroxysms of high body temperature for several hours. Reexposure in one patient resulted in another fever spike 6 hours after ingestion. No other cause of the fever or the granulomatous hepatitis was identifiable. The clinical data, especially the simultanous occurrence of drug fever and the histologic pattern, are compatible with an allergic mechanism of the liver granulomas. In the presence of high fever and abnormal liver tests in relation to nomifensin treatment, an allergic drug reaction should be considered.
本文描述了4例患者，他们在接受诺米芬辛治疗4 - 6周后出现了肉芽肿性肝炎。肉芽肿位于汇管区和肝实质，含有嗜酸性粒细胞和少量多核巨细胞。血清碱性磷酸酶、丙氨酸转氨酶和胆红素分别在3例、2例和1例患者中升高。停药后所有异常在6 - 10周内消失。口服25 - 50毫克诺米芬辛后，所有患者均出现数小时的高热发作。1例患者再次用药后，服药6小时后再次出现发热高峰。未发现发热或肉芽肿性肝炎的其他原因。临床资料，特别是药物热和组织学模式的同时出现，符合肝脏肉芽肿的过敏机制。在与诺米芬辛治疗相关的高热和肝功能异常的情况下，应考虑药物过敏反应。
