title: [Intrahepatic cholestasis and aplastic anemia following administration of prajmaline].
abstract: Intrahepatic cholestasis and aplastic anemia after N-propylajmaline. A 43 year old female patient taking oral contraceptives for more than five years received the antiarrhythmic drug N-propylajmaline for treatment of ventricular arrhythmia. After twelve days (total dosage 510 mg N-propyl-ajmaline) acute severe intrahepatic cholestasis and aplastic anemia developed. The erythropoeisis improved after three weeks of treatment with corticosteroids. However, despite treatment with phenobarbital the jaundice receded very slowly. Even after nine years of follow-up cholestatic enzymes are still significantly elevated although serum bilirubin levels are in the normal range. This case report demonstrates that antiarrhythmic drugs may induce nearly irreversible intrahepatic cholestasis and severe hematological disturbances.
mesh_terms: D000328:Adult; D000404:Ajmaline / Q000031:analogs & derivatives*; D000741:Anemia, Aplastic / Q000139:chemically induced* / Q000473:pathology; D001706:Biopsy; D005117:Cardiac Complexes, Premature / Q000188:drug therapy*; D056486:Chemical and Drug Induced Liver Injury / Q000473:pathology; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D011219:Prajmaline / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000404:Ajmaline; D011219:Prajmaline
vernacular_title: Intrahepatische Cholestase und aplastische Anämie nach Prajmalin-Einnahme.