Low dose amiodarone causing pseudo-alcoholic cirrhosis

Amiodarone is a commonly used anti-arrhythmic in elderly patients. Abnormal liver function is frequently reported with its use but clinically symptomatic disease is rare. Hepatomegaly, cholestasis, acute hepatitis and rarely fulminant liver failure have been recorded [1, 2], however amiodarone toxicity presenting with cirrhosis is exceedingly rare. Toxic effects of amiodarone are well described with higher dosage but severe hepatic toxicity and cirrhosis with low dose amiodarone has not been reported in the English language literature. We present a report on a patient with pseudo-alcoholic cirrhosis with low dose amiodarone.