Hepatotoxicity Due to Treatment with Papaverine

Abstract

Hepatotoxicity due to papaverine was observed in four patients. A cause and effect relation was demonstrated by repeated rechallenge with the drug. The patients had abdominal discomfort, but jaundice was not prominent. Serum alkaline phosphatase and transaminases were elevated. Liver biopsies in Cases 2 and 3 showed numerous eosinophils in the periportal spaces. Both symptoms and signs appeared to be fully reversible. The most likely mechanism is a hypersensitivity reaction.