Allopurinol-induced granulomatous hepatitis with cholangitis and a sarcoid-like reaction.
Allopurinol-induced granulomatous hepatitis with cholangitis and a sarcoid-like reaction.
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别嘌呤醇诱发的肉芽肿性肝炎伴有胆管炎和结节样反应。
DOI：
10.1001/archinte.1978.03630310075024
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发表时间：
1978
影响因子：
--
通讯作者：
B. Nemchausky
中科院分区：
文献类型：
--
作者：
L. Swank;G. Chejfec;B. Nemchausky
36岁男性，双膝疼痛，尿酸浓度升高；他的肝功能正常。开始别嘌呤醇治疗，每次 100 mg，每日两次。一个月后出现发烧、嗜睡和严重的多关节痛。入院时肝功能异常，肝活检标本显示肉芽肿伴胆管炎和胆管周炎。他还患有淋巴细胞减少症、T 细胞数量减少和骨髓肉芽肿。停止别嘌呤醇治疗一个月后，患者临床状况良好，肝功能正常，淋巴细胞计数正常。重复的肝活检标本显示肝组织正常，没有肉芽肿。开始别嘌呤醇治疗后不久出现症状和表现，以及停止治疗后症状和表现消失，提示药物引起的超敏反应。
A 36-year-old man had pain in both knees and an elevated uric acid concentration; his liver function was normal. Allopurinol therapy was started, 100 mg twice daily. After one month fever, lethargy, and severe polyarthralgia developed. On admission to our hospital liver function was abnormal, and a liver biopsy specimen showed granulomas with cholangitis and pericholangitis. He also had lymphopenia with a reduced number of T cells and granulomas in the bone marrow. One month after discontinuation of allopurinol therapy the patient was clinically well with normal liver function and a normal lymphocyte count. A repeated liver biopsy specimen showed normal liver tissue with no granulomas. The onset of the symptoms and findings shortly after the initiation of allopurinol therapy, and their disappearance after the discontinuation of therapy suggest a drug-induced hypersensitivity.