Evaluation of prajmalium-induced cholestasis by immunologic tests

Abstract

Cholestatic jaundice developed in 4 patients after the administration of the antiarrhythmic prajmalium bitartrate. Clinical, histologic, ultrastructural and immunologic findings were determined. In all patients the clinical and morphologic features indicated idiosyncrasy. Two antibodies distributed in a granular pattern along the bile canaliculi were detected by immunofluorescence in all patients. In 1 patient, autoimmune markers were found in the serum, and in 2 instances the migration-inhibition factor assay against the offending drug was positive. Immunologic processes probably participated in the production of the cholestatic syndrome.