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New Emirates Medical Journal

Editor-in-Chief
ISSN (Online): 0250-6882

Case Report

Intravenous Amiodarone-induced Acute Liver Failure: A Case Report and Literature Review

Author(s): Yara Bteich, Jad Hosri, Nagi Nauphal and Nour Ibrahim*

Volume 4, Issue 2, 2023

Published on: 25 July, 2023

Article ID: e160623218048 Pages: 5

DOI: 10.2174/0250688204666230616115448

Price: $0

Abstract

Background: Hepatotoxicity of amiodarone has long been described and consists mostly of mild and delayed onset elevation in liver function tests. Fulminant hepatitis, however, is much rarer and attributed to the parenteral administration of the drug. The mechanism of injury is yet to be understood, though multiple theories have been proposed. This case report aims at highlighting the importance of monitoring patients receiving intravenous amiodarone therapy to detect severe acute liver injury and showcase the appropriate management thereafter.

Case Description: Our patient is a 79-year-old male who presented with epigastric pain that was crampy, intermittent, and aggravated upon exertion. His heart rate was 93 beats/min and cardiac auscultation revealed an irregular heart rhythm. His electrocardiogram revealed atrial fibrillation. He was given intravenous amiodarone with a total dose of 950 mg and developed acute liver failure with extremely elevated liver function tests 48 hours after initiating the drug. After discontinuation, liver function tests returned to baseline within 10 days and the patient was discharged home.

Conclusion: Physicians should be aware of the potentially life-threatening complications, including severe acute liver injury, by closely monitoring liver function tests following the administration of the drug and immediately discontinuing therapy if toxicity was detected.

[1]
Florek JB, Girzadas D. Amiodarone.StatPearls. Treasure Island, FL: StatPearls 2021.http://www.ncbi.nlm.nih.gov/books/NBK482154/ Internet
[2]
Chen CC, Wu CC. Acute hepatotoxicity of intravenous amiodarone. Am J Ther 2016; 23(1): e260-3.
[http://dx.doi.org/10.1097/MJT.0000000000000149] [PMID: 25259952]
[3]
Hashmi A, Keswani NR, Kim S, Graham DY. Hepatic dysfunction in patients receiving intravenous amiodarone. South Med J 2016; 109(2): 83-6.
[http://dx.doi.org/10.14423/SMJ.0000000000000413] [PMID: 26840961]
[4]
Papiris SA, Triantafillidou C, Kolilekas L, Markoulaki D, Manali ED. Amiodarone. Drug Saf 2010; 33(7): 539-58.
[http://dx.doi.org/10.2165/11532320-000000000-00000] [PMID: 20553056]
[5]
Jafari-Fesharaki M, Scheinman MM. Adverse effects of amiodarone. Pacing Clin Electrophysiol 1998; 21(1): 108-20.
[http://dx.doi.org/10.1111/j.1540-8159.1998.tb01068.x] [PMID: 9474655]
[6]
Gluck N, Fried M, Porat R. Acute amiodarone liver toxicity likely due to ischemic hepatitis 2011; 13: 5.
[7]
Fonseca P, Dias A, Gonçalves H, Albuquerque A, Gama V. Acute hepatitis after amiodarone infusion. World J Clin Cases 2015; 3(10): 900-3.
[http://dx.doi.org/10.12998/wjcc.v3.i10.900] [PMID: 26488027]
[8]
Murphy BP, Coldeway J, Raeside DA. Fatal acute fulminant hepatic failure caused by parenteral amiodarone: A case report and review of the literature. Scott Med J 2009; 54(1): 58-8.
[http://dx.doi.org/10.1258/rsmsmj.54.1.58f]
[9]
Chan ALF, Hsieh HJ, Hsieh YA, Lin SJ. Fatal amiodarone-induced hepatotoxicity: a case report and literature review. Int J Clin Pharmacol Ther 2008; 46(2): 96-101.
[http://dx.doi.org/10.5414/CPP46096] [PMID: 18218290]
[10]
Chalasani NP, Hayashi PH, Bonkovsky HL, et al. ACG clinical guideline: the diagnosis and management of idiosyncratic drug-induced liver injury. Off J Am Coll Gastroenterol ACG 2014; 109(7): 950-66.
[11]
Method RUCA. (RUCAM.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases 2012.http://www.ncbi.nlm.nih.gov/books/NBK548272/
[12]
Breuer HW, Bossek W, Haferland C, Schmidt M, Neumann H, Gruszka J. Amiodarone-induced severe hepatitis mediated by immunological mechanisms. Int J Clin Pharmacol Ther 1998; 36(6): 350-2.
[PMID: 9660045]
[13]
James PR, Hardman SM. Acute hepatitis complicating parenteral amiodarone does not preclude subsequent oral therapy. Heart 1997; 77(6): 583-4.
[http://dx.doi.org/10.1136/hrt.77.6.583] [PMID: 9227310]
[14]
Lahbabi M, Aqodad N, Ibrahimi A, Lahlou M, Aqodad H. Acute hepatitis secondary to parenteral amiodarone does not preclude subsequent oral therapy. World J Hepatol 2012; 4(6): 196-8.
[http://dx.doi.org/10.4254/wjh.v4.i6.196] [PMID: 22761971]

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