Intoxication with promethazine as a cause to liver damage
Hunderi, O.H.
Tidsskrift for den Norske Laegeforening Tidsskrift for Praktisk Medicin Ny Raekke 101(29): 1650-1652
1981
ISSN/ISBN: 0029-2001 PMID: 7339949 Document Number: 171925
A patient was admitted to hospital in a coma after ingestion of .apprx. 1500 mg promethazine and some alcohol. He became jaundiced 36 h after admission and the levels of liver enzymes indicated a severe liver cell necrosis. The jaundice lasted for .apprx. 30 days but the serum values for liver enzymes were pathologically raised for .apprx. 3 mo. Biopsy of the liver 1 mo. after admission revealed hepatocellular disarray with varying degrees of liver cell injury and necrosis, periportal infiltration of lymphocytes and signs of cholestasis. The pattern was similar to that of acute viral hepatitis but could also be produced by a drug. A brief description of the symptoms of antihistamine intoxication and possible mechanisms by which liver cell damage was produced were discussed. A possible interaction between promethazine and alcohol was pointed out. Patients already having a latent liver disease may get a fulminant hepatitis if intoxicated by promethazine.
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