Enflurane-induced hepatitis with prominent cholestasis1

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Previously reported cases of enflurane-induced hepatitis share similar clinical, biochemical, and histological features. Systemic symptoms follow a brief latent period after exposure to the anesthetic. Aminotransferase abnormalities predominate and coincide with the histological finding of centrilobular necrosis. The authors describe a case of enflurane-induced hepatitis with typical clinical manifestations associated with mixed hepatocellular and cholestatic liver-function-test abnormalities. Biochemical cholestasis eventually predominated and spuriously simulated an extrahepatic bile duct obstruction. Results of a percutaneous liver biopsy showed a mixed hepatocanalicular drug reaction.



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