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Amiodarone-induced reversible and irreversible hepatotoxicity: two case reports
Toyonobu Tsuda1, Hayato Tada2, Yoshihiro Tanaka1
1Division of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
Journal of Medical Case Reports
|April 15, 2018
Summary
Amiodarone effectively treats arrhythmias but can cause liver injury. Close monitoring and prompt discontinuation are crucial for managing amiodarone-induced hepatotoxicity.
Area of Science:
- Cardiology
- Hepatology
- Pharmacology
Background:
- Amiodarone is a critical antiarrhythmic medication.
- Hepatotoxicity is a known, serious adverse effect of amiodarone therapy.
Observation:
- This report details two Japanese patients experiencing amiodarone-induced liver injury.
- One patient developed irreversible liver damage, progressing to cirrhosis and fatal hepatic failure.
- The second patient exhibited reversible hepatotoxicity, with liver function normalizing after amiodarone withdrawal.
Findings:
- Amiodarone-induced hepatotoxicity can manifest as either reversible or irreversible liver damage.
- Histological and clinical features distinguish between these two outcomes.
- Patient outcomes varied significantly based on the severity and progression of liver injury.
Implications:
- Close monitoring of liver enzymes during amiodarone treatment is essential.
- Liver imaging (CT) and biopsy are valuable diagnostic tools for suspected amiodarone-induced hepatotoxicity.
- Early discontinuation of amiodarone should be strongly considered if hepatotoxicity is suspected to prevent irreversible damage.
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