[Liver damage following clomethacin treatment. 6 cases, including 2 deaths (author's transl)]

The authors report on 6 cases of severe liver damage following clomethacin treatment. Three patients developed prolonged hepatitis, lasting more than 3 months, with biochemical and histological signs of activity; one patient committed suicide by overdosage and died of subacute necrotizing hepatitis; one patient died of chronic cirrhotic hepatitis after prolonged clomethacin-alpha-methyldopa combined treatment, and there was one case of active hepatitis on latent cirrhosis. Drug toxicity was suggested by the presence of jaundice with occasional fever, urticaria or pruritus and eosinophilia, and by the lack of any other cause. It was confirmed in 3 cases by relapse of the condition after re-introduction of the drug, in one case by the circumstances surrounding death (attempted suicide) and in one case by the deterioration observed with increased dosage. In one patient the responsibility of clomethacin was shared with alpha-methyldopa, a potentially hepatotoxic drug.