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Article
April 1960

Hepatocellular Jaundice as a Complication of Iproniazid Therapy

Author Affiliations

Chicago

Fellow in Medicine, Mount Sinai Hospital, and Instructor in Medicine, The Chicago Medical School (Dr. Rosenblum); Chief, Medical Service, Veterans Administration West Side Hospital, and Clinical Assistant Professor of Medicine, University of Illinois College of Medicine (Dr. Korn); Professor and Chairman, Department of Medicine, The Chicago Medical School, and Chairman, Department of Medicine, Mount Sinai Hospital (Dr. Zimmerman).

AMA Arch Intern Med. 1960;105(4):583-593. doi:10.1001/archinte.1960.00270160081010
Abstract

Iproniazid, an amine oxidase inhibitor, originally was tested for its antituberculous properties. When its toxicity appeared to be greater than that of isoniazid, it was abandoned as an antituberculous agent. During this trial period euphoria, increased nervous system activity, and less mental depression were frequently observed. These effects have led to its extensive use in mental illness. Iproniazid has also been suggested for the treatment of rheumatoid arthritis and spondylitis,1,2 intractable angina pectoris,3-5 far-advanced metastatic carcinoma,6 and nontuberculous bone and joint infections.7

Minor side-effects of the drug, including neurologic 3,4,8,9 gastrointestinal,3,8 and genitourinary symptoms,3,8,9 have been reported. These usually have disappeared promptly with the discontinuance of the drug or with reduction of the dose.

A more serious, although infrequent, complication of iproniazid therapy is jaundice. The present report is an analysis of 90 patients who developed jaundice associated with the administration of the drug.

Materials and Methods  The records (or abstracts

References
1.
Hoffman-La Roche, Inc.
2.
Scherbel, A. L.:  The Effect of Isoniazid and of Iproniazid in Patients with Rheumatoid Arthritis ,  Cleveland Clin. Quart. 24:90-97, 1957.Crossref
3.
Banghart, H.:  Effect of Marsilid on the Symptoms of Some of the Rheumatic Diseases ,  J. Clin. & Exper. Psychopath. 19:114-117 ( (Supp. 1) ), 1958.
4.
Master, A. M.:  Iproniazid (Marsilid) in Angina Pectoris ,  Am. Heart J. 56:570-582, 1958.
5.
Cossio, P.:  The Treatment of Angina Pectoris and Other Muscular Pain Due to Ischemia with Iproniazid and Isoniazid ,  Am. Heart J. 56:113-118, 1958.
6.
Cesarman, T.:  Marsilid in the Treatment of Angina Pectoris ,  J. Clin. & Exper. Psychopath. 19:169-177 ( (Supp. 1) ), 1958.
7.
Bateman, J.:  The Role of Marsilid in Patients with Far Advanced Carcinoma ,  J. Clin. & Exper. Psychopath. 19:123-125 ( (Supp. 1) ), 1958.
8.
Bosworth, D. M.; Fielding, J. W.; Acosta, M. G. and Demarest, L. M.:  Use of Iproniazid in Nontuberculous Bone and Joint Infections ,  J.A.M.A. 157:132-136, 1955.
9.
Ogilvie, C. M.:  The Treatment of Pulmonary Tuberculosis with Iproniazid and Isoniazid ,  Quart. J. Med. 24:175-189, 1955.
10.
Smarr, E. R.; Wolf, H., and Pressman, M. D.:  Experiences with Marsilid with Report of One Death ,  Am. J. Psychiat. 114:1115-1116, 1958.
11.
Kahn, M., and Perez, V.:  Jaundice Associated with the Administration of Iproniazid ,  Am. J. Med. 25:898-916, 1958.
12.
Popper, H.:  Pathological Findings in Jaundice Associated with Iproniazid Therapy ,  J.A.M.A. 168:2235-2242, 1958.
13.
Zetzel, L., and Kaplan, H.:  Liver Damage Concurrent with Iproniazid Administration ,  New England J. Med. 258:1209-1211, 1958.
14.
Gradwahl, R. B. H.:  Clinical Laboratory Methods and Diagnosis , Ed. 4, St. Louis, The C. V. Mosby Company, 1948, Vol. 1, p. 411.
15.
Benaim, S., and Dixon, M. F.:  Jaundice Associated with Administration of Iproniazid ,  Brit. M.J. 2:1068-1070, 1958.
16.
Pare, C. M. B., and Sandler, M.:  Acute Hepatic Necrosis Following Iproniazid Therapy ,  Lancet 1:282-284, 1959.
17.
Frantz, A. G.:  Fatal Jaundice Associated with Iproniazid (Marsilid) Therapy ,  J.A.M.A. 167:987-988, 1958.
18.
Shay, H., and Sun, D. C. H.:  Massive Necrosis of the Liver Following Iproniazid ,  Ann. Int. Med. 49:1246-1252, 1958.
19.
Weiss, L. B.; Davidson, J. H.; Winsten, S., and Brody, H.:  Fatal Iproniazid (Marsilid) Hepatitis ,  J. Albert Einstein M. Center 6:229-234, 1958.
20.
Chessin, M.; Dramer, E. R., and Scott, C. C.:  Modifications of the Pharmacology of Reserpine and Serotonin by Iproniazid ,  J. Pharmacol. & Exper. Therap. 119:453-460, 1957.
21.
Floody, R. J.; Dixon, R. E., and Mattia, V. D., Jr.:  Marsilid Toxicity ,  Dis. Nerv. System 19:541-544, 1958.
22.
De Verteuil, R. L., and Lehmann, H. E.:  Therapeutic Trial of Iproniazid (Marsilid) in Depressed and Apathetic Patients ,  Canad. M.A.J. 78:131-133, 1958.
23.
Bosworth, D. M.; Fielding, J. W.; Demarest, L. M., and Bonaquest, M.:  Toxicity to Iproniazid as It Affects Osseous Tuberculosis ,  Sea View Hosp. Bull. 15:134-140, 1954.
24.
Papp, C., and Benaim, S.:  Toxic Effects of Iproniazid in a Patient with Angina ,  Brit. M.J. 2: 1070-1072, 1958.Crossref
25.
Zimmerman, H. J.; Rosenblum, L.; Korn, R. J., and Feldman, P. E.:  Some Preliminary Clinical and Biochemical Aspects of Liver Function in Patients Receiving Iproniazid ,  Ann. New York Acad. Sc. , to be published.
26.
Bosworth, D. M.; Wright, H. A.; Fielding, J. W., and Wilson, H. J.:  The Use of Iproniazid in the Treatment of Bone and Joint Tuberculosis ,  J. Bone & Joint Surg. 35-A:577-588, 1953.
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