Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Various types of allergic accidents have been reported with clometacin (Duperan), a synthetic analgesic introduced in France in 1971. The most prominent is hepatitis in elderly women, with hyperglobulinemia, eosinophilia, autoantibodies and giant multinucleated hepatocytes. The case presented herein concerns a 73-year-old woman who, on two separate occasions after the ingestion of clometacin at recommended dosages, developed at the same time typical acute hepatitis and non-oliguric acute renal failure. The second episode came soon after the medication was inadvertently reintroduced. Both hepatic and renal involvements were fully reversible. A renal biopsy showed predominant lesions of acute interstitial nephritis and tubulonecrosis. Three possible mechanisms are discussed: 1) sensitivity of the kidney to drugs because of preceding angiosclerosis, 2) impaired regulation of renal blood flow because of clometacin provoked decrease of prostaglandin synthesis, and 3) as in the case of nephrotoxicity due to other medications, allergic mechanisms.
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PMID:[Acute renal failure and hepatitis induced by clometacin]. 671 62

The authors report the cases of 4 patients with jaundice following the administration of ajmaline. The disease had a pseudo- angiocholitic onset with fever, chills and pruritus in the 4 patients and abdominal pains in 2 patients. Serum transaminase activity and serum alkaline phosphatase activity were increased in the 4 patients. Blood eosinophilia was found in 3 patients. Liver lesions included predominantly centrilobular cholestasis, mild hepatocytic lesions, and portal inflammation. After the interruption of the drug administration, recovery occurred in the 4 patients. Two patients resumed the intake of ajmaline; transient hepatitis recurred in these 2 patients.
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PMID:[Hepatitis due to ajmaline. Report of cases and review of the literature]. 718 70

The authors report on 6 cases of severe liver damage following clomethacin treatment. Three patients developed prolonged hepatitis, lasting more than 3 months, with biochemical and histological signs of activity; one patient committed suicide by overdosage and died of subacute necrotizing hepatitis; one patient died of chronic cirrhotic hepatitis after prolonged clomethacin-alpha-methyldopa combined treatment, and there was one case of active hepatitis on latent cirrhosis. Drug toxicity was suggested by the presence of jaundice with occasional fever, urticaria or pruritus and eosinophilia, and by the lack of any other cause. It was confirmed in 3 cases by relapse of the condition after re-introduction of the drug, in one case by the circumstances surrounding death (attempted suicide) and in one case by the deterioration observed with increased dosage. In one patient the responsibility of clomethacin was shared with alpha-methyldopa, a potentially hepatotoxic drug.
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PMID:[Liver damage following clomethacin treatment. 6 cases, including 2 deaths (author's transl)]. 729 Sep 27

A report is given of a newborn who developed signs of hepatitis two weeks after a normal birth, and only later respiratory symptoms of pneumonia. The infant had pronounced tachypnea, incresed immunoglobulins, eosinophilia and leucocytosis. X-rays in the initial stages showed interstitial infiltrates with alveolar hyperaeration, and in the later stages patchy alveolar infiltrates. Chlamydia trachomatis was cultured from the tracheal secretion. In making a differential diagnosis in cases of neonatal pneumonia infection with trachomatis must thus also be considered.
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PMID:[Chlamydia trachomatis as pathogen in pneumonia in a newborn infant (author's transl)]. 741 77

Diphenylhydantoine is a drug frequently used in the treatment of epilepsia. In rare occasions, it produces a mulsisystemic manifestation characterized by fever, lymphadenopathy, hepatitis, eosinophilia and desquamative cutaneous eruption, which typically develops within 4-8 weeks after the beginning of the treatment. Mortality rates may reach up to 40% in patients with severe hepatic affection, although the response to steroid therapy is usually frequent. We present the case of a patient which developed a syndrome of hypersensibility to diphenylhydantoine with mononucleosic manifestations, icteric hepatitis and exfoliative dermatitis, who completely recovered a few days after his hospitalization.
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PMID:[Phenytoin hypersensitivity syndrome]. 765 2

The eosinophilia-myalgia syndrome associated with L-tryptophan-containing products is highlighted by eosinophilia, incapacitating myalgias, and diverse multisystemic manifestations. In addition to involvement of the skin, skeletal muscle, and peripheral nerves, visceral damage has been quite prominent, particularly affecting the lungs, the heart, and the liver. Hepatic involvement has been manifested by altered liver tests but is clinically silent. We report the unique case of a woman with this syndrome who developed abdominal pain, a clinical picture of hepatitis and chronically abnormal liver tests. Histologic examination of the liver disclosed eosinophilic hepatitis with piecemeal necrosis. The occurrence of clinically overt hepatic involvement has not been reported previously. Potential mechanisms of liver damage in eosinophilia-myalgia syndromes are discussed.
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PMID:Eosinophilic hepatitis: a new feature of the clinical spectrum of the eosinophilia-myalgia syndrome. 783 24

In a 39-year-old woman an anticonvulsant therapy was initiated because of focal attacks in the left arm and face. The patient experienced generalized maculopapular skin rashes in response to each of four chemically similar anticonvulsant drugs: phenytoin, carbamazepine, primidone and clonazepam. During administration of carbamazepine the clinical features included fever, hepatitis and hematological eosinophilia in addition to the skin rash (anticonvulsant hypersensitivity syndrome). The anticonvulsant hypersensitivity syndrome is defined as an idiosyncratic reaction caused by disturbed drug metabolism. Positive lymphocyte-transformation tests with carbamazepine and phenytoin indicate an immunological mechanism underlying the rashes in our patient. Patch testing with the four anticonvulsant drugs gave positive results only with carbamazepine. Skin biopsy showed the histological features of a delayed-type allergy. The anticonvulsant therapy was continued with a chemically unrelated preparation, valproic acid; this drug is well tolerated and has proved appropriate for prevention of seizures.
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PMID:[Anticonvulsant hypersensitivity syndrome to carbamazepine]. 792 47

Severe skin adverse drug reactions can result in death, but the rate of such events is fortunately low. The incidences of Stevens-Johnson syndrome and toxic epidermal necrolysis range from 1.2 to 6 per million per year and 0.4 to 1.2 per million per year, respectively. Stevens-Johnson syndrome is fatal in about 5% and toxic epidermal necrolysis in 30% of cases. Drugs implicated in these diseases are the sulphonamides, anticonvulsants, allopurinol, pyrazolone derivatives, oxicams and chlormezanone. The principles of symptomatic treatment are the same as for burns, and patients with extensive skin detachment should be transferred to an intensive care unit or a burn centre. Hypersensitivity syndrome is characterised by mucocutaneous eruption and fever with frequent lymphadenopathy, hepatitis and eosinophilia. Drugs implicated are mainly anticonvulsants and sulphonamides. The mortality rate of such a reaction has been estimated to be about 8%. Corticosteroid therapy has been widely used in hypersensitivity syndrome, despite the lack of controlled studies. Drug-induced vasculitis and serum sickness may also be life-threatening when the kidney, liver, gastrointestinal tract or nervous system are involved. In angioedema, congestion may involve mucous membranes and therefore impair swallowing and ventilation. Drugs associated with angioedema include penicillins, radiographic contrast agents and ACE inhibitors. Severe forms of angioedema necessitate epinephrine (adrenaline) subcutaneous injection and possibly resuscitative efforts. Corticosteroids and/or antihistamines are used to block or reduce prolonged or late phase reactions. Prompt recognition and withdrawal of the suspected drug is essential in severe drug-induced skin reactions.
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PMID:Drug-induced severe skin reactions. Incidence, management and prevention. 852 20

Carbamazepine is a drug commonly used in the treatment of neuropathic pain. It is an iminostilbene derivative that is extensively metabolized by the liver. We describe a 66-year-old man with dysesthetic pain from cervical myelopathy who developed cholestatic hepatitis, skin rash, and eosinophilia after carbamazepine was administered for 5 weeks (total dose of 18.9gm). Withdrawal of carbamazepine led to complete resolution of both clinical and biochemical abnormalities within 3 weeks. Clinicians should be alert to this rare complication because it can be confused clinically with biliary tract sepsis and viral hepatitis.
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PMID:Carbamazepine-induced hepatitis in a patient with cervical myelopathy. 860 Aug 77

Toxocariasis is a cosmopolitan infection of dogs and cats with a roundworm resembling Ascaris. Man becomes infected by ingesting eggs from the environment. The infection occurs mainly in children. There are two distinct syndromes: visceral larva migrans and ocular toxocariasis. The author describes the case of a 70 year old Norwegian female with visceral larva migrans. One month after a visit to Spain she developed fever, hepatomegaly and marked eosinophilia. Liver biopsy revealed subacute hepatitis with eosinophilic leucocyte infiltration. Toxocara ELISA was strongly positive. Treatment with albendazol 400 mg b.i.d. and prednisone 10 mg daily for three weeks was successful. A clinical relapse after three months was treated in the same way for one month. Prolonged treatment is recommended. To our knowledge, this is the first reported case of visceral larva migrans in an adult Norwegian. Epidemiology, diagnosis and treatment are discussed.
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PMID:[Visceral larva migrans. A rare cause of eosinophilia in adults]. 892 42


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