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Hepatotoxicity of amiodarone
R Jeyamalar1, R Pathmanathan, D Wong
1Department of Medicine, University Hospital, Kuala Lumpur, Malaysia.
Annals of the Academy of Medicine, Singapore
|November 1, 1992
Summary
Long-term amiodarone use can cause liver damage (hepatotoxicity), even in patients without symptoms. This case report details a patient who developed cirrhosis after prolonged amiodarone therapy, emphasizing the need for monitoring.
Area of Science:
- Cardiology
- Hepatology
- Pharmacology
Background:
- Amiodarone is a widely prescribed antiarrhythmic medication.
- Adverse effects associated with amiodarone therapy are common.
- Hepatotoxicity is an uncommon but serious complication of amiodarone.
Observation:
- A 76-year-old male patient with ischemic heart disease and ventricular tachycardia was treated with amiodarone.
- After 11 months, the patient showed asymptomatic elevations in liver enzymes, which normalized upon drug withdrawal.
- Upon reintroduction of amiodarone, the patient later developed hepatomegaly, abnormal liver function tests, and histological evidence of cirrhosis.
Findings:
- Prolonged amiodarone administration can lead to significant liver injury, including cirrhosis.
- Liver enzyme elevations may be asymptomatic initially.
- Discontinuation of amiodarone led to symptom improvement, but some abnormalities persisted.
Implications:
- This case underscores the importance of vigilant liver function monitoring in patients on long-term amiodarone.
- Hepatotoxicity should be considered in patients on amiodarone presenting with abnormal liver tests.
- Early recognition and drug withdrawal are crucial for managing amiodarone-induced liver injury.