Fatal Acute Hepatitis Due to Amodiaquine

Jm, Raymond; Dumas, Frédéric; Baldit, C; Couzigou, P; Béraud, C; Amouretti, M

doi:10.1097/00004836-198910000-00034

Cited by 21 publications

(12 citation statements)

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“…55 Fatal acute hepatitis due to amodiaquine has been reported. 56,57 Combination antimalarial therapy is being explored to delay development of resistance to falciparum malaria. Orrell et al reported acute asymptomatic hepatitis in a healthy normal volunteer exposed to two oral doses of amodiaquine and artesunate.…”

Section: Jaundice Due To Drugsmentioning

confidence: 99%

Jaundice in malaria

Anand

Puri

2005

J of Gastro and Hepatol

110

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Jaundice is not an unusual accompaniment of malaria. It can occur due to intravascular hemolysis, disseminated intravascular coagulation, and, rarely, 'malarial hepatitis'. Although the primary schizogony of the malarial parasite always leads to the rupture of the infected hepatocyte, alteration of the hepatic functions is uncommonly recorded due to this event. Histologically, the hepatitis or the actual inflammation in the liver has never been demonstrated. Nonetheless, the term 'malarial hepatitis' (MH) has been used in the literature to describe the occurrence of hepatocellular jaundice in patients with Plasmodium falciparum infection. The authors' own data and review of the literature indicate that it is not an uncommon entity. In endemic areas, jaundice is seen in approximately 2.5% of patients with falciparum malaria. It also appears to be a heterogeneous syndrome and one can recognize two clinical subsets. In one group there was an acute, virulent presentation with coma, renal failure and in some cases even hemorrhagic manifestations. It is only in this setting that jaundice signified a 'severe' disease as noted by the World Health Organization action program. This presentation is often confused with acute viral hepatitis and acute hepatic failure in non-endemic areas, but can be clinically differentiated.

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Section: Jaundice Due To Drugsmentioning

confidence: 99%

Jaundice in malaria

Anand

Puri

2005

J of Gastro and Hepatol

110

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“…Prophylactic administration of the antimalarial amodiaquine dihydrochloride dihydrate (AQ) has been associated with serious adverse reactions includ ing agranulocytosis and hcpatotoxicity which have on occasion proved fatal [1][2][3]. In contrast, treatment of malaria with AQ is not usually associated with drug toxicity.…”

Section: Introductionmentioning

confidence: 99%

Detection of Antidrug IgG Antibodies in Patients with Adverse Drug Reactions to Amodiaquine

Clarke

Neftel²,

Kitteringham

et al. 1991

Int Arch Allergy Immunol

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Antidrug IgG antibodies have been detected in some patients receiving amodiaquine (AQ). Antidrug antibodies were detected in 6/7 patients who experienced serious well-defined adverse drug reactions during malaria prophylaxis and in 7/22 patients who received comparable doses of the drug (at least 400 mg weekly ×6) but did not present with clinical adverse drug reactions. In contrast antidrug antibodies were not detected in 7 patients who received the drug for treatment (1.0–1.2 g total over 3 days). The specificity of the IgG response was defined by hapten inhibition experiments (IC₅₀ value for AQ ranged between 0.050 and 0.282 μM) which suggest that the antibody recognised the drug linked to cysteine residues in protein via the 4-hydroxyanilino side chain. The data show that AQ is immunogenic in man and are consistent with the hypothesis that idiosyncratic adverse reactions to the drug have an immunological aetiology.

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“…Amodiaquinelinduced -hepatitis during malaria prophylaxis is well described and may be associated with neutropenia (LARREY et al, 1986;NEFTEL et al, 1986;WOODTLI et al, 1986;CHARMOT & GOUJON, 1987;BERNUAU et al, 1988;RAYMOND et al, 1989). These side-effects are thought to be immune mediated but the pathogenesis remains unclear (CLARKE et al, 1991).…”

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confidence: 99%

“…Clinically, reported cases have ranged from a mild, transient elevation of liver enzymes With few symptoms (LARREY et al, 1986;CHARMOT & GOUTON. 1987) NEFTEL et al, 1986), or death (NEFTEL et al, 1986;BEFWUAU et al, 1988;RAYMOND et al, 1989). …”

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confidence: 99%