Diagnosis of Drug-Induced Hepatitis by Determination of Serum Enzyme Activities

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Nine cases of clinically suggested drug-induced hepatitis were diagnostically confirmed by determination of serum enzyme activities following provocative readministration of causative agents.Animal experimentation was also performed.1) The cases studied consisted of 6 cases induced by erythromycin estolate (EME) and 1 case each by tetracycline, potassium phenethicillin and arsphenamin natrium respectively.Their symptoms and liver function tests were discussed.2) After recovery of their clinical course, the 9 cases were readministrated about half a daily dose of their respective causative agents. The activities of glucose-6-phosphatase (G6P), phosphohexose isomerase, aldolase (ALD), lactic dehydrogenase, malic dehydrogenase, glutathione reductase, isocitric dehydrogenase (ICD), GOT, GPT, alkaline phosphatase and Ieucine aminopeptidase were chronologically determined. In 24-48 hours all cases showed a marked increase in G6P, ICD and ALD, but a slight increase in transaminases. A few cases complained of fever, abdominal pain or jaundice, showing increased transaminases.3) Three control subjects who had experience of administration of EME showed no positive provocation sign on determination of serum enzyme activities.4) Rabitts were intramusculary injected of 2-hydroxy-methylene-17α-methyl dihydrotestosterone (HMD) (3mg/kg) once daily 21 times following a ligation of the left renal pedicle. After recovery of their disturbed serum enzyme activities by discontinuance of injection, they were readministrated HMD and examined as to the activities.The results obtained were almost identical with those of human cases.
財団法人日本消化器病学会の論文

Diagnosis of Drug-Induced Hepatitis by Determination of Serum Enzyme Activities

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