Hepatitis with fibrin-ring granulomas.

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.

journal_name

Infection

journal_title

Infection

authors

Khanlari B,Bodmer M,Terracciano L,Heim MH,Fluckiger U,Weisser M

doi

10.1007/s15010-007-6365-8

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

381-3

issue

4

eissn

0300-8126

issn

1439-0973

journal_volume

36

pub_type

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