Horst D A, Grace N D, LeCompte P M
Gastroenterology. 1980 Sep;79(3):550-4.
This report describes a middle-aged female who received imipramine for 7 days, developed severe cholestatic jaundice with features similar to primary biliary cirrhosis, and then improved clinically over the next 12 mo. Biochemical and histologic abnormalities persisted over a 14-yr period of follow-up, though subsequent administration of haloperidol may have influenced the long-term course. High levels of circulating immune complexes were also found 14 yr later, which raises questions about the relationship of primary biliary cirrhosis to drug-induced liver injury. A review of the literature on imipramine- and phenothiazine-related hepatic injuries reveals multiple similarities, and this case provides further evidence for a common hepatic reaction to the two drugs.
本报告描述了一名中年女性，她接受丙咪嗪治疗7天后出现了严重的胆汁淤积性黄疸，其特征类似于原发性胆汁性肝硬化，随后在接下来的12个月中临床症状有所改善。在14年的随访期间，生化和组织学异常持续存在，尽管随后使用氟哌啶醇可能影响了长期病程。14年后还发现循环免疫复合物水平升高，这引发了关于原发性胆汁性肝硬化与药物性肝损伤之间关系的疑问。对有关丙咪嗪和吩噻嗪相关肝损伤的文献综述显示出多种相似之处，该病例为这两种药物引起的共同肝脏反应提供了进一步证据。
