Morphologic Alterations in Patients with Alpha-Methyldopa-induced Liver Damage after Short- and Long-term Exposure

Abstract

Alpha-methyldopa-induced histologic alterations were investigated in 31 patients with hepatic injury after short- and long-term exposure. Patients (7) developed liver injury within 6 mo. and 24 after several yr (mean, 5 yr) of exposure. Histologic findings and clinical and biochemical data differed significantly in the 2 groups. Morphologic analysis of the short-term-treated group revealed marked parenchymatous degeneration, focal, confluent and massive necrosis and inflammation. Fatty accumulation and increased fibrous trabeculae were characteristic for patients treated for the long term. All patients in the short-term-exposed group had acute and severe hepatitis, and 4 had icterus. Two patients died of hepatic coma. Patients in the long-term-treated group had for several months, initially mild but increasing discomfort, dyspepsia, nausea and colic. Liver function tests in these groups revealed differences in serum albumin, bilirubin and transferase levels. No changes were observed in alkaline phosphatase and trombotest. Fat accumulation and fibrous trabeculae suggested that the alterations preceded the clinical symptoms and biochemical signs of hepatitis.