Accession Number	<strong>00042737-200108000-00018</strong>.
Author	Grieco, Antonio a; Alfei, Barbara a; Di Rocco, Paola a; Miele, Luca a; Biolcati, Gianfranco c; Griso, Daniela c; Vecchio, Fabio Maria b; Bianco, Alessandro a; Gasbarrini, Giovanni a
Institution	(a)Istituto di Medicina Interna e Geriatria and (b)Istituto di Anatomia Patologica, Universita' Cattolica del Sacro Cuore, Facolta' di Medicina 'A. Gemelli', Rome, Italy and (c)Istituto Dermatologico S. Maria e S. Gallicano, IRCCS, Rome, Italy
Title	Non-alcoholic steatohepatitis induced by carbamazepine and variegate porphyria.[Report]
Source	European Journal of Gastroenterology & Hepatology. 13(8):973-975, August 2001.
Abstract	A 42-year-old woman presented with acute bullous skin lesions and angio-oedema that had developed 3 months after initiation of treatment with carbamazepine for epilepsy. Chromatographic analysis of urinary porphyrins was compatible with variegate porphyria. This was manifested initially by neurological symptoms that were mistaken for epilepsy and later by cutaneous symptoms also. Histological findings excluded hepatic porphyria, but revealed severe fatty changes thought to be caused by idiosyncratic metabolism of carbamazepine. While the porphyrinogenicity of carbamazepine is well known, the presence of variegate porphyria has not been reported. The toxic hepatic effects of the drug on hepatic cytochrome P-450, which is involved in haem metabolism, could have aggravated the pre-existent porphyria, provoking the onset of skin lesions. (C) 2001 Lippincott Williams & Wilkins, Inc.