piperidines and Hepatitis--Alcoholic

The authors describe a case of cirrhogenic hepatitis due to Pexid which was given for 8 months at 400 mg/day for a severe angina pectoris. We find here the anatomo-clinical profile of perhexiline maleate hepatiits already described in approximately 20 cases. There was a cirrhogenic evolution in our case as in 5 others : but here cirrhosis was revealing and seems stabilized since the treatment was stopped. The cirrhogenic evolution could be due to a cumulative effect of the drug and/or to an immuno-allergic mechanism as in alcoholic cirrhosis which is very similar, especially from an anatomical point of view. However cirrhogenic hepatitis differs by a characteristic lysosomal overload : brown pigment under microscopic observation and lipolysosomes with in some cases a lamellar structure under electron microscopic observation. The prescription of such a drug should be limited to cases of refractory angina pectoris and needed a regular clinical and biological survey.

Topics: Aged; Angina Pectoris; Chemical and Drug Induced Liver Injury; Diagnosis, Differential; Female; Hepatitis, Alcoholic; Humans; Liver; Liver Cirrhosis; Perhexiline; Piperidines

Topics: Angina Pectoris; Chemical and Drug Induced Liver Injury; Diagnosis, Differential; Female; Genes; Hepatitis, Alcoholic; HLA Antigens; HLA-B Antigens; Humans; Middle Aged; Perhexiline; Piperidines

Two middle-aged men, who had received perhexiline in recommended dosage, showed clinical and histological evidence of severe hepatic damage, and one of them died. Histological study of the livers showed a striking resemblance to alcoholic hepatitis.

Topics: Chemical and Drug Induced Liver Injury; Diagnosis, Differential; Hepatitis, Alcoholic; Humans; Liver; Liver Diseases; Male; Middle Aged; Perhexiline; Piperidines

Topics: Angina Pectoris; Diagnosis, Differential; Hepatitis, Alcoholic; Humans; Liver Cirrhosis; Male; Middle Aged; Perhexiline; Piperidines; Time Factors