Key result
Intravenous amiodarone administration caused acute hepatotoxicity in a 72-year-old woman, with hepatic parameters returning to normal immediately after treatment discontinuation.
Why the study?
Does intravenous amiodarone cause acute hepatotoxicity in a patient with multiple comorbidities?
Case Report (n=1)
Does intravenous amiodarone cause acute hepatotoxicity in a patient with multiple comorbidities?
Intravenous amiodarone can rarely cause severe acute hepatotoxicity, highlighting the need for close liver function monitoring during administration.
Supports hepatic monitoring with IV amiodarone; single case leaves open incidence and risk quantification.
OBJECTIVE: To report a fatal case of amiodarone-induced acute hepatotoxicity after intravenous amiodarone administration and similar fatal cases review. CASE SUMMARY: A 72-year-old woman with a history of hypertension, prior cardiovascular disease, atrial fibrillation and diabetes mellitus was admitted to the hospital with acute pyelonephritis and transferred to the intensive care unit due to cerebral infarction. An antidiabetic drug, a low dose of aspirin and intravenous amiodarone therapy was started. After receiving a second dose of amiodarone (1,200 mg; injection rate 1 mg/min), the woman developed ascites, jaundice, high levels of serum transaminases, decreased prothrombin time, and finally became unconscious. Immediately after treatment was discontinued, her extremely high hepatic parameters returned to normal. According to the Naranjo probability scale, this adverse reaction was highly probable. DISCUSSION: The occurrence of acute liver damage after intravenous amiodarone is rare but harmful. It can be induced by polysorbate 80, a solubilizer, by immunomediated centrilobular necrosis, or by the presence of a functional PPAR-I+/- gene. CONCLUSION: Amiodarone is an effective antiarrhythmic agent for preventing and treating atrial and ventricular arrhythmias. The molecular mechanism causing acute hepatic damage after amiodarone treatment is not clear. Therefore, amiodarone must be administered with care, and liver function should be monitored closely in patients treated with this drug.
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Chan et al. (2008) conducted a case report in amiodarone-induced acute hepatotoxicity (n=1). Intravenous amiodarone was evaluated on acute hepatotoxicity. Intravenous amiodarone administration caused acute hepatotoxicity in a 72-year-old woman, with hepatic parameters returning to normal immediately after treatment discontinuation.
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