title: [Acute hepatitis following administration of fansidar].
abstract: Since 1971 pyrimethamine-sulfadoxine (Fansidar, Roche) has been used worldwide for prophylaxis and therapy of chloroquine resistant Plasmodium falciparum malaria. The drug monitoring team of the producing firm has received reports of a number of cutaneous adverse reactions, some severe, and a few even with fatal outcome. Liver reactions were also encountered, with severe cases only in the recent literature. We report on two patients with hepatitis in temporal relationship to pyrimethamine-sulfadoxine, the first with a second event after later exposure to the same drug. After discontinuing the medication the liver function abnormalities returned to normal limits within a few weeks. Liver biopsy and a positive lymphocyte transformation test against sulfadoxine, a component of Fansidar, strongly suggest that Fansidar was the cause of hepatic injury.
authors.affiliation: Medizinische Klinik, Spital Neumünster, Zollikerberg.
authors.forename: P
authors.initials: P
authors.lastname: Meier
authors.forename: M
authors.initials: M
authors.lastname: Schmid
authors.forename: M
authors.initials: M
authors.lastname: Stäubli
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000962:Antimalarials / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000201:enzymology / Q000209:etiology*; D004338:Drug Combinations / Q000009:adverse effects; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D011739:Pyrimethamine / Q000009:adverse effects*; D013413:Sulfadoxine / Q000009:adverse effects*; D013424:Sulfanilamides / Q000009:adverse effects*
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D013424:Sulfanilamides; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D011739:Pyrimethamine
vernacular_title: Akute Hepatitis nach Einnahme von Fansidar.