ajmaline and Cholestasis--Intrahepatic

Topics: Ajmaline; Alanine Transaminase; Alkaline Phosphatase; Anti-Arrhythmia Agents; Bilirubin; Biomarkers; Brugada Syndrome; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Female; Humans; Middle Aged; Serum Albumin; Serum Albumin, Human; Time Factors

Intrahepatic cholestasis and aplastic anemia after N-propylajmaline. A 43 year old female patient taking oral contraceptives for more than five years received the antiarrhythmic drug N-propylajmaline for treatment of ventricular arrhythmia. After twelve days (total dosage 510 mg N-propyl-ajmaline) acute severe intrahepatic cholestasis and aplastic anemia developed. The erythropoeisis improved after three weeks of treatment with corticosteroids. However, despite treatment with phenobarbital the jaundice receded very slowly. Even after nine years of follow-up cholestatic enzymes are still significantly elevated although serum bilirubin levels are in the normal range. This case report demonstrates that antiarrhythmic drugs may induce nearly irreversible intrahepatic cholestasis and severe hematological disturbances.

Topics: Adult; Ajmaline; Anemia, Aplastic; Biopsy; Cardiac Complexes, Premature; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Diagnosis, Differential; Female; Humans; Liver; Liver Function Tests; Prajmaline

Topics: Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Cholestasis, Intrahepatic; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Prajmaline

It is reported on lesions of the liver parenchyma after the application of dihydralazin and detajmium bitartrate with description of the clinical and morphological findings. By means of the morphological findings got in liver biopsy a clinically supposed acute virus hepatitis could be excluded. After the application of dihydralazin group cell necroses and an inflammation of the periportal fields, after detajmium bitartrate a typical intrahepatic cholestasis was in the front. The knowledge of medicamentous side-effects may avoid diagnostic and therapeutic errors in the individual case.

Topics: Adult; Ajmaline; Biopsy; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Dihydralazine; Female; Humans; Hydralazine; Liver; Necrosis

Topics: Aged; Ajmaline; Arrhythmias, Cardiac; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Drug Hypersensitivity; gamma-Glutamyltransferase; Humans; Liver Diseases; Male; Transaminases

Topics: Ajmaline; Bile Ducts; Bile Ducts, Intrahepatic; Cholestasis, Intrahepatic; Humans; Jaundice; Jaundice, Obstructive; Rauwolfia