title: Anti-amiodarone antibodies: detection and relationship to the development of side effects.
abstract: OBJECTIVE
  It has become evident in the past few years that amiodarone, a powerful antiarrhythmic agent, induces considerable side effects. These may be due to an amiodarone-elicited lipid storage disease and to the iodine content of amiodarone, but might also be causally related to amiodarone-induced immune reactions. The latter possibility prompted us to develop a sensitive anti-amiodarone antibody detection assay based on the immunodot technique.
  
  
  METHODS
  Sera were obtained from 10 untreated control subjects and 33 patients receiving amiodarone. Using serum dilutions of 1:500 and 1:1,000, the lower detection limit was 0.3 microgram/ml of anti-amiodarone antibodies as calculated from a simultaneously performed IgG standard curve.
  
  
  RESULTS
  Screening of sera from the untreated control subjects and amiodarone-treated patients revealed that the untreated subjects had no anti-amiodarone antibodies, that only one of 16 patients without clinical side effects had elevated anti-amiodarone antibodies, but that seven of 12 patients with amiodarone-induced thyroid disease and four of five patients with other side effects had elevated anti-amiodarone antibody titers (1.2 to 2.5 micrograms/ml). The combined evaluation of anti-amiodarone antibody titers and cumulative dose was found to be a highly reliable indicator of side effects, as all patients with more than 100-g cumulative dose of amiodarone and more than 0.6 microgram/ml of anti-amiodarone antibodies had side effects.
  
  
  CONCLUSIONS
  The detection of anti-amiodarone antibodies in patients with amiodarone-elicited side effects underscores the possible contribution of immunologic reactions to the development of certain side effects.
authors.affiliation: Institute of Clinical Immunology, Inselspital, Bern, Switzerland.
authors.forename: W J
authors.initials: WJ
authors.lastname: Pichler
authors.forename: L
authors.initials: L
authors.lastname: Schindler
authors.forename: M
authors.initials: M
authors.lastname: Stäubli
authors.forename: B M
authors.initials: BM
authors.lastname: Stadler
authors.forename: A L
authors.initials: AL
authors.lastname: de Weck
mesh_terms: D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D000906:Antibodies / Q000032:analysis*; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D013959:Thyroid Diseases / Q000150:complications / Q000276:immunology
chemical_list: D000906:Antibodies; D000638:Amiodarone