Bories P, Pomier-Layrargues G, Chotard J P, Citron D, Capron-Chivrac D, Capron J P, Michel H
Nouv Presse Med. 1980 Dec 20;9(48):3689-92.
The authors have observed 5 cases of cholestatic jaundice with cytolysis during treatment with amineptine, a new tricyclic compound recently made available. The responsibility of the drug was virtually certain for the following reasons: (a) there was no other cause of jaundice, such as viral infection, gallstones, toxic agents or association with other hepatotoxic drugs; (b) clinical and biochemical findings were similar in all patients; (c) in 2 patients, reintroduction of the drug after temporary withdrawal resulted in rapid recurrence of the condition, with the same symptoms and course. The shorter delay (2 and 8 days instead of 11 and 18 days) between absorption of amineptine and reappearance of the symptoms in these two patients is suggestive of an immunoallergic mechanism.
作者观察到5例在使用新近上市的三环类化合物安咪奈丁治疗期间出现胆汁淤积性黄疸伴细胞溶解的病例。基于以下原因，药物的责任几乎可以确定：（a）不存在其他黄疸病因，如病毒感染、胆结石、有毒物质或与其他肝毒性药物联用；（b）所有患者的临床和生化表现相似；（c）2例患者在暂时停药后重新使用该药物，病情迅速复发，症状和病程相同。这两名患者中，安咪奈丁吸收与症状再次出现之间的延迟较短（分别为2天和8天，而非11天和18天），提示存在免疫过敏机制。
