[A case of cholestatic hepatitis caused by amiodarone]

The authors report the case of a 70 year old male patient, who was treated with amiodarone for 9 months (200 mg/d-5 days/7) for alcohol-induced hypokinetic cardiomyopathy, complicated by ventricular dysrhythmia and hospitalized for jaundice, pruritus, and deterioration of his general condition. Alkaline phosphatases were elevated significantly (7 times the upper limit for normal) with a moderate rise in serum transaminases twice the upper limit for normal). Ultrasound of the liver and biliary tract was normal. There were no serum markers for hepatitis B virus. No anti-tissue antibodies were found. A liver biopsy revealed portal and septal fibrosis, and polymorphous inflammatory infiltration with a majority of polymorphonuclear neutrophils and Mallory bodies. Intracellular and intralysosomal phospholipid inclusions were observed with electron microscopy. Clinical and laboratory test value outcome was favorable two weeks after cessation of administration of amiodarone.