Rosenberg J L, Edlow D, Sneider R
Arch Intern Med. 1978 Jun;138(6):989-91.
Hypersensitivity reactions to cromolyn sodium occur rarely. On several occasions they have been associated with peripheral eosinophilia and granulomatous inflammation. Liver disease has not been reported previously as a complication of inhaled cromolyn. We describe here a woman in whom marked peripheral eosinophilia, liver disease, and systemic vasculitis developed while taking cromolyn and resolved or improved on discontinuation of the drug and treatment with corticosteroids. The liver disease was similar to primary biliary cirrhosis except that marked eosinophilic infiltration and granulomas were present initially. Studies of the patient's serum for binding of carbon 14-labeled cromolyn, the skin for deposits of the drug, and the circulating lymphocytes for stimulation by cromolyn failed to demonstrate any abnormalities. However, the elevated IgG and IgM levels, the positive rheumatoid factor and antimitochondrial antibody, and the reduced serum complement, which returned to normal on discontinuation of the drug therapy, suggests that immunologic mechanisms may have played a role in the pathogenesis of this patient's illness.
对色甘酸钠的过敏反应很少发生。有几次，它们与外周嗜酸性粒细胞增多和肉芽肿性炎症有关。此前尚未有肝脏疾病作为吸入色甘酸钠并发症的报道。我们在此描述一名女性，她在服用色甘酸钠期间出现了明显的外周嗜酸性粒细胞增多、肝脏疾病和系统性血管炎，在停药并接受皮质类固醇治疗后症状缓解或改善。该肝脏疾病与原发性胆汁性肝硬化相似，只是最初存在明显的嗜酸性粒细胞浸润和肉芽肿。对患者血清进行14碳标记色甘酸钠结合研究、皮肤进行药物沉积研究以及循环淋巴细胞进行色甘酸钠刺激研究，均未发现任何异常。然而，IgG和IgM水平升高、类风湿因子和抗线粒体抗体阳性以及血清补体降低，在停药治疗后恢复正常，这表明免疫机制可能在该患者疾病的发病机制中起了作用。
