Hepatitis with fibrin-ring granulomas.
Infection
; 36(4): 381-3, 2008 Aug.
Article
em En
| MEDLINE
| ID: mdl-17926000
ABSTRACT
We describe a 66-year-old woman hospitalized with fever, fatigue and hepatopathy. In her medical history arterial hypertension (treated with propranolol and lisinopril), diabetes mellitus type 2 (no treatment before admission) and a gout arthropathy were noted wherefore a therapy with allopurinol 300 mg per day has been started 4 months before. Liver biopsy revealed fibrin-ring granulomas, compatible with allopurinol-induced hepatitis. Because of persistence of high fever after stopping allopurinol, steroids (1 mg/kg) were started. Under this treatment, she developed pancytopenia and fever. The bone marrow aspiration revealed Leishmania infantum. A second liver biopsy showed amastigotes and a disappearance of the granulomas. The history revealed a travel to Malta 2 years earlier. Despite adequate treatment with liposomal amphotericin B the patient deteriorated and finally died in septic shock.
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Bases de dados:
MEDLINE
Assunto principal:
Fibrina
/
Doença Hepática Induzida por Substâncias e Drogas
/
Granuloma
/
Leishmaniose Visceral
/
Fígado
Tipo de estudo:
Diagnostic_studies
Limite:
Aged
/
Animals
/
Female
/
Humans
Idioma:
En
Revista:
Infection
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Suíça