Thomas E, Rosenthal W S, Zapiach L, Micci D
Am J Gastroenterol. 1977 Aug;68(2):125-33.
The administration of alpha methyldopa resulted in serious liver injury to seven patients, requiring hospitalization. All patients presented with symptoms indistinguishable from viral hepatitis. Histological changes ranged from those compatible with acute hepatitis to chronic active hepatitis and subacute hepatic necrosis. One patient with subacute hepatic necrosis rapidly progressed to hepatic failure and died; autopsy revealed postnecrotic cirrhosis. Inadvertent rechallenge after recovery resulted in dramatic recurrence of symptoms in one patient, confirming the fact that a hypersensitivity phenomenon is involved. A high state of awareness among physicians of this unpredictable toxic effect of the drug may reduce its unrecognized perpetuation.
α-甲基多巴的使用导致7名患者出现严重肝损伤，需要住院治疗。所有患者的症状与病毒性肝炎难以区分。组织学变化范围从符合急性肝炎到慢性活动性肝炎以及亚急性肝坏死。一名患有亚急性肝坏死的患者迅速进展为肝衰竭并死亡；尸检显示为坏死后肝硬化。一名患者康复后意外再次用药导致症状急剧复发，证实了存在过敏现象这一事实。医生对该药物这种不可预测的毒性作用保持高度警惕，可能会减少其未被认识到的持续影响。
