A case of carbimazole-induced intrahepatic cholestasis. An immune-mediated reaction?
A patient is described with cholestatic hepatitis following the use of carbimazole. A liver biopsy specimen showed intracanalicular cholestasis and some mononuclear cell infiltrate in the portal triades, consistent with drug toxicity; indications of an autoimmune or viral pathogenesis were absent. Rechallenge with the drug precipitated jaundice and disturbed liver function once more. Carbimazole induced a blastogenic response of patient lymphocytes in vitro. Both may suggest the involvement of an immune-mediated reaction, especially as it has been shown that sensitized lymphocytes may produce a cholestatic factor on stimulation with antigen.
D000368:Aged; D001652:Bile Ducts / Q000276:immunology; D002231:Carbimazole / Q000009:adverse effects*; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D004247:DNA / Q000096:biosynthesis; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000473:pathology; D008213:Lymphocyte Activation / Q000187:drug effects; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology
D002231:Carbimazole; D004247:DNA