Amiodarone-induced reversible and irreversible hepatotoxicity: two case reports

J Med Case Rep. 2018 Apr 14;12(1):95. doi: 10.1186/s13256-018-1629-8.

Abstract

Background: Amiodarone is a highly effective treatment for supraventricular and ventricular tachyarrhythmia; however, it could be associated with several serious adverse effects, including liver injury.

Case presentation: We report the clinical and histological features of two contrasting Japanese patients with amiodarone-induced reversible and irreversible hepatotoxicity. One patient with amiodarone-induced irreversible hepatotoxicity showed liver cirrhosis during treatment with amiodarone and died of hepatic failure; the other patient, who had reversible hepatotoxicity, showed a reversible course of liver function and imaging after discontinuation of amiodarone.

Conclusions: We emphasize the importance of close monitoring of liver enzymes and evaluation of liver computed tomographic imaging as well as liver biopsy during treatment with amiodarone, and discontinuation should be considered when amiodarone-induced hepatotoxicity is suspected.

Keywords: Amiodarone; Hepatotoxicity.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Alanine Transaminase / blood
  • Amiodarone / adverse effects*
  • Amiodarone / blood
  • Anti-Arrhythmia Agents / adverse effects*
  • Anti-Arrhythmia Agents / blood
  • Aspartate Aminotransferases / blood
  • Chemical and Drug Induced Liver Injury / diagnosis*
  • Fatal Outcome
  • Humans
  • Liver Cirrhosis / chemically induced*
  • Liver Cirrhosis / diagnostic imaging
  • Liver Function Tests
  • Male
  • Non-alcoholic Fatty Liver Disease / chemically induced*
  • Non-alcoholic Fatty Liver Disease / diagnostic imaging
  • Tachycardia, Ventricular / drug therapy
  • Tomography, X-Ray Computed

Substances

  • Anti-Arrhythmia Agents
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Amiodarone