Adverse hepatic outcome associated with long-term use of amiodarone
10.3760/cma.j.cn114015-20220414-00322
- VernacularTitle:长期服用胺碘酮致肝脏不良结局
- Author:
Liuyi CHANG
1
;
Xiuhong ZU
;
Zhonghua LUAN
;
Weimin WANG
Author Information
1. 山西省运城市中心医院消化内科，运城 044000
- Publication Type:Journal Article
- Keywords:
Amiodarone;
Drug-induced liver injury;
Adverse outcome
- From:
Adverse Drug Reactions Journal
2023;25(2):117-120
- CountryChina
- Language:Chinese
-
Abstract:
A 77-year-old male patient received amiodarone 0.2 g twice daily orally for arrhythmia. After 15 months of amiodarone treatment, he developed some symptoms such as poor appetite, reduced diet, nausea and vomiting, and dysphagia. After 22 months of amiodarone treatment, laboratory tests showed white blood cell count 13.5×10 9/L, neutrophil 0.78, C-reactive protein 117.4 mg/L, erythrocyte sedimentation rate 32 mm/1 h, alanine aminotransferase (ALT) 286 U/L, aspartate aminotransferase (AST) 215 U/L, alkaline phosphatase (ALP) 107 U/L, γ-glutamyl transferase (γ-GT) 45 U/L, total bilirubin (TBil) 14.8 μmol/L, direct bilirubin 9.3 μmol/L, and albumin 30 g/L. After treatments with anti-infection, hepatoprotection, and albumin supplementation, the above symptoms were improved and amiodarone was continued. After 40 months of amiodarone treatment, laboratory tests showed ALT 87 U/L, AST 106 U/L, ALP 308 U/L, γ-GT 1 242 U/L, and TBil 11.2 μmol/L. According to the results of liver biopsy, it is suspected that the patient was alcoholic liver fibrosis. After excluding alcoholic liver disease, viral hepatitis, autoimmune liver disease, and tumors by imaging and liver biopsy, it was considered to be associated with long-term use of amiodarone. Amiodarone was withdrawn, but the patient died 3 months later because of ascites and jaundice.
