Key result
IV amiodarone linked to acute multi-organ toxicity in a patient with AF.
Why the study?
Acute multi-organ toxicity during 24-hour intravenous amiodarone dosing is a rare and under-recognized clinical phenomenon.
Does intravenous amiodarone cause acute multi-organ toxicity in a patient with heart failure and atrial fibrillation?
Case Report (n=1)
No
Does intravenous amiodarone cause acute multi-organ toxicity in a patient with heart failure and atrial fibrillation?
Acute amiodarone-induced multi-organ toxicity should be considered in patients presenting with sudden dyspnea, elevated transaminases, and AKI within 1-2 days of initial IV dosing.
Acute multi-organ toxicity may occur with 24-hour IV amiodarone; this single case leaves open incidence, causality, and risk factors.
We present a unique case of a 60-year-old male with congestive heart failure who was admitted for a pre-syncopal episode and found to be in atrial fibrillation with rapid ventricular response (RVR). In order to effectively rate control the patient, he was administered an amiodarone bolus and intravenous (IV) infusion over 24 hours, along with a single oral 200 mg dose the following day. The patient subsequently developed acute hepatotoxicity along with features of acute kidney injury (AKI), pulmonary distress, and leukocytosis. After ruling out other etiologies for acute liver, pulmonary, and kidney injury, amiodarone-induced multi-organ toxicity was suspected and amiodarone was discontinued. Within hours of amiodarone discontinuation, the patient's clinical status and organ function improved remarkably. In the setting of a patient being treated with IV amiodarone and presenting with sudden signs of dyspnea, acute elevation of transaminases and AKI within one to two days of initial dosing, acute amiodarone-induced organ toxicity should be considered.
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Liwag et al. (2022) conducted a case report in Atrial fibrillation with rapid ventricular response (n=1). Amiodarone was evaluated on Acute multi-organ toxicity (hepatotoxicity, acute kidney injury, and pulmonary distress). Intravenous amiodarone administration over 24 hours in a 60-year-old male with atrial fibrillation resulted in acute multi-organ toxicity, including hepatotoxicity, acute kidney injury, and pulmonary distress.
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