cefpiramide and Chemical-and-Drug-Induced-Liver-Injury

Drug-induced allergic hepatitis occurred in a patient being treated with cefpiramide sodium. A lymphocyte blast transformation test suggested that the N-methyltetrazolethiol group of the drug was responsible for the induction of acute hepatitis. A detailed case report and discussion of the relevant literature are presented in this paper.

Topics: Acute Disease; Adult; Cephalosporins; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Female; Humans; Lymphocyte Activation

Pharmacokinetics of cefpiramide (CPM) were investigated in normal rats and rats with hepatic intoxication induced by a single oral administration of carbon tetrachloride (CCl4). The elimination half-life of the antibiotic was prolonged in CCl4-intoxicated rats and the total body clearance in CCl4-intoxicated rats (153.9 ml/h/kg) was about 40% of the control value (390.3 ml/h/kg), while the volume of distribution for CPM was scarcely affected. The hepatic clearance of CPM was markedly diminished and the renal clearance of CPM was slightly, but not significantly, decreased in CCl4-intoxicated rats. It seems that the hepatic clearance of CPM was decreased owing to at least two factors; (1) decrease in CPM uptake by hepatocytes and (2) decrease in bile flow, while the renal clearance of CPM was slightly decreased owing to decrease in the renal tubular secretion. These results suggest that CCl4 intoxicates not only the liver but also the kidney to a small extent.

Topics: Animals; Bile; Blood Proteins; Carbon Tetrachloride Poisoning; Cephalosporins; Chemical and Drug Induced Liver Injury; Drug Interactions; In Vitro Techniques; Liver; Liver Diseases; Male; Metabolic Clearance Rate; Protein Binding; Rats; Rats, Inbred Strains

A case of systemic lupus erythematosus (SLE) with mononucleosis-like hepatic injury was described. An emergent cesarean section was performed in a 25 yr-old house wife at 34 weeks gestation, followed by administration of several antibiotics. After the surgery she complained of high fever, hepatomegaly and dull right hypochondralgia, and mild liver dysfunction was also found. The liver biopsy showed prominent mononuclear cell infiltration in the sinusoids with minimum hepatocellular necrosis and mild triaditis, resembling hepatic lesion in infectious mononucleosis (mononucleosis-like injury). There were no clinical and serological features suggestive of infectious mononucleosis. This hepatic lesion was thought to be a manifestation of allergic reaction to drugs to which the lymphocyte stimulation test was found to be positive. Immunological abnormalities inherent in SLE might be related to occurrence of such allergic drug reaction.

Topics: Adult; Cefoxitin; Cephalosporins; Chemical and Drug Induced Liver Injury; Dibekacin; Female; Humans; Indomethacin; Infectious Mononucleosis; Lupus Erythematosus, Systemic