HEPATIC DAMAGE ASSOCIATED WITH SULFONAMIDE THERAPY IN INFANTS AND CHILDREN. I. MORPHOLOGIC PATHOLOGY

Abstract

In 299 consecutive necropsies performed during the 3 yrs. ending Apr. 1, 1942, 38 instances of hepatic degenerative changes associated with sulfonamide therapy were observed. Focal toxic necrosis of the liver occurred in 3 children. Toxic central necrosis was seen to a varying extent in the livers of 9 children. When the drug was given by mouth, the central necrosis was seen grossly only in the outer half or two-thirds of the right lobe of the liver, which distribution corresponds to the area of liver supplied by the superior mesenteric artery. In intraven. drug therapy, the distribution of the toxic central necrosis grossly was fairly uniform throughout the liver. In the remaining 26 children, serous hepatitis and beginning toxic central necrosis were observed. Comparison of a similar number of necropsies in previous yrs. revealed a much lower incidence of such pathologic conditions in the liver.