DRUG-INDUCED HEPATOCELLULAR LIVER-INJURY DUE TO BENZYLPENICILLIN WITHEVIDENCE OF LYMPHOCYTE SENSITIZATION

Background/Aims: Reports on drug-induced liver injury due to benzylpen icillin are scarce and predominantly describe cases of intrahepatic ch olestasis. To our knowledge, no immunologically documented case of hep atocellular liver injury due to benzylpenicillin has been reported so far. Case Report: A previously healthy man required longterm therapy w ith benzylpenicillin because of vertebral spondylitis. After 4 weeks o f treatment, liver tests showed a marked increase in transaminases ass ociated with high peripheral eosinophil counts, Discontinuation of ben zylpenicillin resulted in gradual recovery. Investigations: Levels of eosinophil cationic protein were elevated, indicating eosinophil activ ition and the presence of an immunoallergic reaction. Skin tests and a ssays for specific Ig E-antibodies to benzylpenicillin were negative, but lymphocyte transformation tests demonstrated T-cell sensitization to benzylpenicillin. Conclusions: According to current causality asses sment schemes, our report constitutes a probable case of drug-induced hepatocellular liver injury due to benzylpenicillin.