[Cefotaxime-induced allergic agranulocytosis in an acute attack of serologically atypical primary biliary cirrhosis].

A 35-year-old woman developed pharyngitis with high fever and painful joint swellings. A severe cholestatic hepatitis occurred 40 days later with a rise of bilirubin to 32 mg/dl. "Nuclear dot" antibodies were demonstrated in the immunofluorescence test on cell cultures, confirming a diagnosis of primary biliary cirrhosis which had followed an atypical course. After nine days of cefotaxime administration, commenced because of persistent fever of 40 degrees C, an agranulocytosis was demonstrated, which regressed within a week of discontinuing the drug. The allergic genesis of the agranulocytosis was proven by repeated lymphocyte stimulation tests in the presence of cefotaxime. The autoimmune hepatitis was probably a predisposing factor in the genesis of the allergically induced agranulocytosis.