Characteristics of clometacin-induced hepatitis with special reference to the presence of anti-actin cable antibodies.
The clinical, biochemical, histopathological and immunological features of 30 cases of clometacin-induced hepatitis are described. The age range of the patients was 32-84 years with a notable female predominance of 29:1. The hepatitis was highly cytolytic with high values of transaminases but with little or no cholestasis. Gammaglobulins were higher than 18 g/l in 73% of the cases. 25 liver biopsies were performed and showed acute hepatitis with a predominant centrilobular necrosis in 17; chronic aggressive hepatitis was noted in 8 cases but 1 showed concomitant cirrhotic changes. Anti-tissue antibodies were looked for in all cases. Anti-smooth muscle antibodies of anti-actin cable type (titre 1/80 to 1/2, 560) were detected in 19 cases, anti-nucleus antibodies in 16 cases which were associated to the former in 14 cases. The above findings show that clometacin produces a hepatitis syndrome quite akin to autoimmune chronic active hepatitis (lupoid hepatitis) and to the hepatopathy induced by oxyphenisatin.
Islam
S
S
Laboratoire Central d'Immunologie et d'Hématologie Hôpital Saint-Antoine, Paris.
Mekhloufi
F
F
Paul
J M
JM
Islam
M
M
Johanet
C
C
Legendre
C
C
Degott
C
C
Abuaf
N
N
Homberg
J C
JC
D000199:Actins / Q000276:immunology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000139:chemically induced / Q000276:immunology / Q000473:pathology; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000139:chemically induced; D007210:Indoleacetic Acids / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000276:immunology; D012737:Sex Factors
D000199:Actins; D000700:Analgesics; D001323:Autoantibodies; D007210:Indoleacetic Acids; C017136:clometacin