Amiodarone induced epididymitis in children.
OBJECTIVE
Amiodarone is an antiarrythmic agent, which is often successfully used when all other antiarrythmics have failed. Sterile epididymitis is a recognized complication of treatment in adults, occurring in up to 11% of patients. To date there have been no reported cases of amiodarone induced epididymitis in children. We present a previously unrecognized cause of epididymitis in boys.


METHODS
The medical records, including radiographic imaging, pathology and operative reports, of 2 postpubertal boys who had sterile epididymitis after prolonged therapy with amiodarone were reviewed.


RESULTS
In both cases the onset of scrotal pain and subsequent evaluation led to diagnosis of epidydimitis. Amiodarone was determined to be the cause, and cessation of the drug resulted in symptom resolution in 1 case.


CONCLUSIONS
While it remains uncertain, the pathophysiology of amiodarone induced epididymitis is likely related to its high concentration in testicular tissue. Recognition that amiodarone is a rare but significant cause of epididymitis in children is important to prevent unnecessary surgery in high risk patients. Amiodarone induced epididymitis in children tends to be a self-limited process and of secondary importance to the serious cardiac disease. Whereas discontinuing amiodarone risks sudden cardiac death, a reduction in dosage or temporary cessation of the drug may result in rapid resolution of the epididymitis.
Department of Urology, Children's Hospital, Boston, Massachusetts 02115, USA.
J
J
Hutcheson
C A
CA
Peters
D A
DA
Diamond
D000293:Adolescent; D000328:Adult; D000638:Amiodarone / Q000008:administration & dosage / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy; D002648:Child; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004823:Epididymitis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D010146:Pain / Q000139:chemically induced; D011859:Radiography; D012307:Risk Factors; D012611:Scrotum / Q000187:drug effects; D017180:Tachycardia, Ventricular / Q000188:drug therapy; D013737:Testis / Q000187:drug effects; D018879:Ventricular Premature Complexes / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone