Zafrani E S, Ishak K G, Rudzki C
Dig Dis Sci. 1979 May;24(5):385-96. doi: 10.1007/BF01297126.
A combined cholestatic and hepatocellular injury occurred in nine patients, following therapy with erythromycin estolate (EE) or other erythromycin derivatives. Eight of the nine patients developed jaundice within three weeks after initiation of treatment; pain was one of the main symptoms in five patients while fever and itching were noted in four patients. Symptoms and signs subsided and abnormal tests of liver function returned to normal after withdrawal of the drug. The major histologic finding was cholestasis, but the majority of cases also had evidence of hepatocellular injury of variable severity; one biopsy specimen showed centrilobular necrosis. Ultrastructural findings in one case included changes related to cholestasis as well as hepatocellular injury with striking mitochondrial abnormalities. Our data are compared with those of the literature, with special reference to morphologic features.
九名患者在接受依托红霉素（EE）或其他红霉素衍生物治疗后出现了胆汁淤积和肝细胞损伤合并的情况。九名患者中有八名在开始治疗后的三周内出现黄疸；五名患者的主要症状之一是疼痛，四名患者出现发热和瘙痒。停药后症状和体征消退，肝功能异常检查结果恢复正常。主要的组织学发现是胆汁淤积，但大多数病例也有不同程度肝细胞损伤的证据；一份活检标本显示小叶中心坏死。一例患者的超微结构发现包括与胆汁淤积相关的变化以及伴有显著线粒体异常的肝细胞损伤。我们的数据与文献中的数据进行了比较，特别参考了形态学特征。
