Dincsoy H P, Saelinger D A
Gastroenterology. 1982 Sep;83(3):694-700.
A 15-yr-old patient with chronic cholestatic liver disease associated with haloperidol therapy is presented. Emphasis is placed on the pattern of biochemical abnormalities and on the histologic features observed in the four serial biopsies which demonstrated a pronounced injury to the bile duct epithelium, correlating well with the clinical and biochemical abnormalities. During the early stage of illness, the clinicopathologic features simulated obstructive jaundice, whereas a resemblance to chronic chlorpromazine-induced cholestasis or primary biliary cirrhosislike syndrome was striking as the chronicity developed. Comparison is made of the features in our patient with those in 2 patients with biopsy-documented, acute haloperidol-induced liver disease reported for the first time in 1977. Despite the lack of concrete evidence, both the clinical and morphologic features, and the close temporal relationship between the medication and onset of illness in this patient led to the reasonable inference that haloperidol was responsible for the chronic cholestatic reaction on a hypersensitivity basis.
本文报告了一名15岁患有慢性胆汁淤积性肝病的患者，该疾病与氟哌啶醇治疗有关。重点关注生化异常模式以及在四次连续活检中观察到的组织学特征，这些活检显示胆管上皮有明显损伤，与临床和生化异常密切相关。在疾病早期，临床病理特征类似梗阻性黄疸，而随着病程发展，与慢性氯丙嗪诱导的胆汁淤积或原发性胆汁性肝硬化样综合征相似。将我们患者的特征与1977年首次报道的2例经活检证实的急性氟哌啶醇诱导性肝病患者的特征进行了比较。尽管缺乏确凿证据，但该患者的临床和形态学特征以及药物与疾病发作之间的密切时间关系，合理推断氟哌啶醇在超敏反应基础上导致了慢性胆汁淤积反应。
