Abstract
Recently several cases of specific phospholipid fatty liver were reported, also the relationship of these cases with 4, 4'-diethylaminoethoxy hexestrol dihydrochloride (Dh drug) was discussed, and this relationship was confirmed by experimental animal study.
A case at our hospital was 66-year-old woman who had been medicated with Dh drug for the treatment of hypertension and heart disease. She was hospitalized with marked hepatomegaly, and laboratory examination revealed an accelerated erythrocyte sedimentation, CRP positive, marked hyperlipidemia and increase of acid phosphatase value. Lucent hepatic foam cells and blood foam cells were found by histological examination, and electronmicroscopic examination revealed numerous myelin-like “lamellar materials” in hepatic cells and in bone marrow cells.
Liver homogenate and acetone powder of rat liver were prepared, and were used as enzymes for metabolic study of Dh drug. Phosphate buffer and glycylglycine buffer with ATP were used as a medium of reaction, of which the latter system showed a higher hexestrol production, a reaction product, than the former, using TLC analysis.
Diethylaminoethyl alcohol as a substrate of choline phosphokinase, and the roleof this compound in the phospholipid synthesis were discussed. Also MER-25 which has diethylaminoethoxy phenyl in its chemical structure was mentioned in relation to anti-estrogen and phospholipid biosynthesis.
