著者

加藤 博之 西原 学宣 大森 啓造 須永 俊明 徳永 蔵

出版者

日本救急医学会

雑誌

日本救急医学会雑誌 (ISSN:0915924X)

巻号頁・発行日

vol.4, no.1, pp.38-44, 1993-02-15 (Released:2009-03-27)

参考文献数

26

---

A case of drug-induced fulminant hepatitis is reported. A 48-year-old female was transferred to Saga Medical School Hospital because of fever, general fatigue, jaundice and marked liver dysfunction after being treated by her private physician with several drugs containing antibiotics and aspirin DL-lysine. On admission, prothrombin time was prolonged (13%), but the patient's consciousness was clear. Viral markers for hepatitis A, B and C were negative. On the fourth hospital day, consciousness disturbance (hepatic coma: grade IV) developed, and despite intensive treatment including glucagon-insulin therapy and plasma exchange, the patients died of hepatic coma with multiple organ failure on the eleventh hospital day. The liver weighed 710g, and exhibited features of massive necrosis histologically. The lymphocyte stimulating test was positive for cefmetazol and aspirin DL-lysine. A review of literature showed that in Japan about 5% of cases of fulminant hepatitis are due to drugs other than halothane. In most cases reported recently, the lymphocyte stimulating test has been positive for the causative drugs.