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August 1985

A Case of Carbimazole-Induced Intrahepatic Cholestasis: An Immune-Mediated Reaction?

Author Affiliations

From the Department of Internal Medicine, St Luke's Hospital (Drs Blom, Stolk, and Schreuder), and the Department of Immunopathology, Academic Hospital, Free University (Dr von Blomberg-van der Flier), Amsterdam.

Arch Intern Med. 1985;145(8):1513-1515. doi:10.1001/archinte.1985.00360080195029

• 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.

(Arch Intern Med 1985;145:1513-1515)