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2000
Volume 4, Issue 2
  • ISSN: 0250-6882
  • E-ISSN: 0250-6882

Abstract

Background

Hepatotoxicity of amiodarone has long been described and consists mostly of mild and delayed onset elevation in liver function tests. Fulminant hepatitis, however, is much rarer and attributed to the parenteral administration of the drug. The mechanism of injury is yet to be understood, though multiple theories have been proposed. This case report aims at highlighting the importance of monitoring patients receiving intravenous amiodarone therapy to detect severe acute liver injury and showcase the appropriate management thereafter.

Case Description

Our patient is a 79-year-old male who presented with epigastric pain that was crampy, intermittent, and aggravated upon exertion. His heart rate was 93 beats/min and cardiac auscultation revealed an irregular heart rhythm. His electrocardiogram revealed atrial fibrillation. He was given intravenous amiodarone with a total dose of 950 mg and developed acute liver failure with extremely elevated liver function tests 48 hours after initiating the drug. After discontinuation, liver function tests returned to baseline within 10 days and the patient was discharged home.

Conclusion

Physicians should be aware of the potentially life-threatening complications, including severe acute liver injury, by closely monitoring liver function tests following the administration of the drug and immediately discontinuing therapy if toxicity was detected.

© 2023 The Author(s). Published by Bentham Science Publisher. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2023-07-25
2025-07-09
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References

  1. FlorekJ.B. GirzadasD. Amiodarone.StatPearls.InternetTreasure Island, FLStatPearls2021http://www.ncbi.nlm.nih.gov/books/NBK482154/
    [Google Scholar]
  2. ChenC.C. WuC.C. Acute hepatotoxicity of intravenous amiodarone.Am. J. Ther.2016231e260e26310.1097/MJT.000000000000014925259952
    [Google Scholar]
  3. HashmiA. KeswaniN.R. KimS. GrahamD.Y. Hepatic dysfunction in patients receiving intravenous amiodarone.South. Med. J.20161092838610.14423/SMJ.000000000000041326840961
    [Google Scholar]
  4. PapirisS.A. TriantafillidouC. KolilekasL. MarkoulakiD. ManaliE.D. Amiodarone.Drug Saf.201033753955810.2165/11532320‑000000000‑0000020553056
    [Google Scholar]
  5. Jafari-FesharakiM. ScheinmanM.M. Adverse effects of amiodarone.Pacing Clin. Electrophysiol.199821110812010.1111/j.1540‑8159.1998.tb01068.x9474655
    [Google Scholar]
  6. GluckN. FriedM. PoratR. Acute amiodarone liver toxicity likely due to ischemic hepatitis.2011135
    [Google Scholar]
  7. FonsecaP. DiasA. GonçalvesH. AlbuquerqueA. GamaV. Acute hepatitis after amiodarone infusion.World J. Clin. Cases201531090090310.12998/wjcc.v3.i10.90026488027
    [Google Scholar]
  8. MurphyB.P. ColdewayJ. RaesideD.A. Fatal acute fulminant hepatic failure caused by parenteral amiodarone: A case report and review of the literature.Scott. Med. J.2009541585810.1258/rsmsmj.54.1.58f
    [Google Scholar]
  9. ChanA.L.F. HsiehH.J. HsiehY.A. LinS.J. Fatal amiodarone-induced hepatotoxicity: a case report and literature review.Int. J. Clin. Pharmacol. Ther.20084629610110.5414/CPP4609618218290
    [Google Scholar]
  10. ChalasaniNP HayashiPH BonkovskyHL ACG clinical guideline: the diagnosis and management of idiosyncratic drug-induced liver injury.Off J Am Coll Gastroenterol ACG.20141097950966
    [Google Scholar]
  11. MethodR.U.C.A. (RUCAM.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. DrugI.L.I. Bethesda, MDNational Institute of Diabetes and Digestive and Kidney Diseases2012http://www.ncbi.nlm.nih.gov/books/NBK548272/
    [Google Scholar]
  12. BreuerH.W. BossekW. HaferlandC. SchmidtM. NeumannH. GruszkaJ. Amiodarone-induced severe hepatitis mediated by immunological mechanisms.Int. J. Clin. Pharmacol. Ther.19983663503529660045
    [Google Scholar]
  13. JamesP.R. HardmanS.M. Acute hepatitis complicating parenteral amiodarone does not preclude subsequent oral therapy.Heart199777658358410.1136/hrt.77.6.5839227310
    [Google Scholar]
  14. LahbabiM. AqodadN. IbrahimiA. LahlouM. AqodadH. Acute hepatitis secondary to parenteral amiodarone does not preclude subsequent oral therapy.World J. Hepatol.20124619619810.4254/wjh.v4.i6.19622761971
    [Google Scholar]
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