Eugene C, Lefebvre J F, Gury B, Quevauvilliers J
Sem Hop. 1983 Nov 17;59(42):2923-4.
A seventy-one-year-old woman presented with jaundice (total bilirubinemia 91 microM, conjugated bilirubinemia 76 microM) and cytolysis (ALAT greater than 6 N) after ten days of pentoxifylline-ticlopidine combination therapy. Blood count was normal excepting transient anemia. Protein electrophoresis was normal. Jaundice resolved 10 days after both drugs had been discontinued. Viral serology (B, A, nonA-nonB, mononucleosis, cytomegalovirus, herpes simplex virus) was negative. Ultrasonography and cholecystography were normal. Responsibility of a drug is therefore likely and we are inclined to incriminate ticlopidine as two similar cases have previously been observed.
一名71岁女性在接受己酮可可碱-噻氯匹定联合治疗10天后出现黄疸(总胆红素血症91微摩尔/升,结合胆红素血症76微摩尔/升)和细胞溶解(丙氨酸转氨酶大于6倍正常上限)。除了短暂性贫血外,血细胞计数正常。蛋白电泳正常。在停用两种药物10天后黄疸消退。病毒血清学检查(乙肝、甲肝、非甲非乙肝炎、单核细胞增多症、巨细胞病毒、单纯疱疹病毒)均为阴性。超声检查和胆囊造影正常。因此很可能是药物所致,鉴于之前曾观察到两例类似病例,我们倾向于认定噻氯匹定有罪。