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Granulomatous Hepatitis: A Hypersensitivity Response to Procainamide

HESCHI H. ROTMENSCH, M.D.; ISRAEL YUST, M.D.; YARDENA SIEGMAN-IGRA, M.D.; MEIR LIRON, M.D.; BIANCA ILIE, M.D.; and NURITH VARDINON, Ph.D.
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Tel Aviv Municipal-Governmental Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Aviv, Israel


Ann Intern Med. 1978;89(5_Part_1):646-647. doi:10.7326/0003-4819-89-5-646
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Adverse side effects of procainamide have been the subject of many reports, with emphasis on the lupus-type syndrome that commonly occurs after prolonged exposure to the drug (1). Febrile reactions and chills are uncommon manifestations of procainamide hypersensitivity and appear within 1 to 2 weeks after the first dose in a nonsensitized person (2). Hepatitis associated with procainamide is an even less common complication of this agent and has been described in two instances (3, 4). In neither of these cases was a liver biopsy done.

We report here the case of a patient who developed fever, chills, and a

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