A case of drug-induced liver injury with positive LE phenomenon caused by mercazole

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  • KOBAYASHI Michio
    1st Department of Internal Medicine, Mie University School of Medicine (Tsu)
  • HIGASHIYAMA Satoru
    1st Department of Internal Medicine, Mie University School of Medicine (Tsu)
  • NAKAGIRI Syunji
    1st Department of Internal Medicine, Mie University School of Medicine (Tsu)
  • ITO Toshiaki
    1st Department of Internal Medicine, Mie University School of Medicine (Tsu)
  • TAKASE Kojiro
    1st Department of Internal Medicine, Mie University School of Medicine (Tsu)
  • HAGIWARA Masayoshi
    1st Department of Internal Medicine, Mie University School of Medicine (Tsu)
  • TAMEDA Yukihiko
    1st Department of Internal Medicine, Mie University School of Medicine (Tsu)
  • KOSAKA Yoshitane
    1st Department of Internal Medicine, Mie University School of Medicine (Tsu)

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Other Title
  • メルカゾールによりじゃっ起されたＬＥ現象陽性肝障害の１例
  • メルカゾール ニ ヨリ ジャッキサレタ LE ゲンショウ ヨウセイ カン ショ

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Abstract

A 38 year-old female patient with hyperthyroidism was treated with mercazole at a dose of 30mg per day. 15 days after starting therapy, Al-P, LAP and γ-GTP increased, and on the 20th day Al-P rose to 44K.A.U., LAP to 392 G.R.U. and γ-GTP to the extreme of 216mU, respectively. On the 25th day jaundice was observed and on the 50th day T-Bil rose to 37mg/dl. But transaminase was within the normal range throughout the treatment.<BR>The liver biopsy specimen showed marked cholestasis in the area of the central vein. Parenchymal change and cell infiltration in the portal tracts were slightly present.<BR>LE phenomenon on the 20th day and antinuclear antibody on the 27th day were seen to be positive, which was thought to be induced by mercazole.<BR>In addition, thiurazile also caused liver injury and the lymphocyte stimulation test was positive to both mercazole and thiurazile. From the view point of drug cross reaction, the existence of a thioamide radical seems to be important.<BR>These observations indicate a drug-induced intrahepatic cholestasis caused by mercazole.

Journal

  • Kanzo

    Kanzo 22 (10), 1453-1459, 1981

    The Japan Society of Hepatology

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