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Cimetidine-induced hepatitis

Electron microscopic observations and clinical pattern of liver injury

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Summary

A 36-year-old man without evidence of previous liver disturbance developed hepatitis during recovery from bleeding duodenal ulcer and under therapy with a maintenance dose of 400 mg of cimetidine.

A 75-day interval between the drug administration and the development of hepatitis was observed. A liver biopsy specimen displayed acute hepatitis with spotty necrosis and accumulation of iron-containing pigment in portal histiocytes and Kupffer cells. Electron microscopic examination showed diffuse accumulation of bile pigment in liver cells. Smooth endoplasmic reticulum, mitochondria, and other organelles of the hepatocytes appeared otherwise normal. Rash and musculoskeletal pain suggested a hypersensitivity type of reaction. Results of functional tests returned to normal 24 days after drug withdrawal. Reexposure of the patient to the drug was followed by trasient reappearance of most symptoms and signs of the hepatic reaction. Until now, there has been no extensive study of liver morphology in cimetidine-induced hepatic injury.

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Authors and Affiliations

  1. Cell Pharmacology and Digestive Disease Units, University of Ancona, Ancona, Italy

    Ivano Lorenzini MD, Anne Marie Jezequel MD & Francesco Orlandi MD

  2. Department of Gastroenterology, School of Medicine and General Hospital of Ancona, CP 538, 60100, Ancona, Italy

    Ivano Lorenzini MD, Anne Marie Jezequel MD & Francesco Orlandi MD

Authors
  1. Ivano Lorenzini MD
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  2. Anne Marie Jezequel MD
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  3. Francesco Orlandi MD
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Additional information

This study was supported by a research grant, 7901910.04, Consiglio Nazionale delle Ricerche, Roma.

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Lorenzini, I., Jezequel, A.M. & Orlandi, F. Cimetidine-induced hepatitis. Digest Dis Sci 26, 275–280 (1981). https://doi.org/10.1007/BF01391643

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  • DOI: https://doi.org/10.1007/BF01391643

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