Acute hepatic injury induced by intravenous amiodarone: clinical case analysis and review of the literature
10.3760/cma.j.issn.1008-5734.2018.05.008
- VernacularTitle:静脉应用胺碘酮致急性肝损伤临床病例分析及文献复习
- Author:
Yunjuan SU
1
;
Yuqing SONG
1
;
Qian DONG
1
;
Liu YANG
1
;
Yongfu CHEN
1
;
Sujuan ZHANG
1
;
Qiming WU
1
Author Information
1. 100015,首都医科大学附属北京地坛医院心内科
- Publication Type:Journal Article
- Keywords:
Amiodarone;
Injections,intravenous;
Chemical and drug induced liver injury
- From:
Adverse Drug Reactions Journal
2018;20(5):359-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical characteristics,prevention,and treatment of acute liver injury (AHI) induced by intravenous amiodarone.Methods The medical records data of 5 patients with AHI caused by intravenous amiodarone in our hospital were collected and retrospectively analyzed,and in the meantime,case reports on intravenous amiodarone-induced AHI in PubMed,CNKI and Wanfang Data were searched.The clinical data of 5 patients in our hospital and case reports from the literature were summarized and the clinical characteristics of AHI induced by intravenous amiodarone were analyzed.Results The 5 patients with AHI induced by intravenous amiodarone in our hospital included 3 males and 2 females with ages of 22-70 years.The total doses of amiodarone were 450-750 mg,incubation periods (the period from drug use to AHI occurrence) were 24-48 h,and the types of liver injury were all hepatocyte type,of which 2 patients' were liver failure.A total of 59 patients with amiodarone-induced AHI were collected (5 in our hospital and 54 from the literature),including 40 males (67.8％) and 19 females (32.2％) with ages from 1 year and 10 months to 93 years and a median age of 69 (58,75) years.In these 59 patients,the incubation periods ranged from 6 hours to 8 days and the median period was 2 (1,3) days,and that of 55 patients (93.2％) were less than or equal to 3 days.The incubation periods of 17 patients with liver failure and 42 patients with non-liver failure were 1 (1,2) days and 2 (1,3) days respectively,and the difference was statistically significant (P =0.033).The peak values of ALT,which were recorded in 55 patients,ranged from 178 to 8 400 U/L,and the median value was 2 418 (922,4 250) U/L.The peak values of AST,which were recorded in 56 patients,ranged from 165 to 17 471 U/L,and the median value was 2 658 (1 205,7 250)U/L.The AST peak values of 16 patients with liver failure and 42 patients with non-liver failure were 6 195 (3 370,6 850) U/L and 2 383 (1 115,5 040) U/L,respectively,and the difference was statistically significant (P =0.032).Among the 59 AHI patients,44 patients' liver function returned to normal,4 patients' liver function improved,and 11 patients died,of whom 9 (81.8％) developed liver failure.Conclusion AHI induced by intravenous amiodarone is an acute onset and severe disease with a short incubation period,and should be monitored timely.
