Rapid acute amiodarone-induced hepatotoxicity in a burn patient.
Acute burn and trauma patients have a higher frequency of cardiac arrhythmias than would be expected for noncardiac-hospitalized patients. Amiodarone is an effective, commonly used drug for cardiac arrhythmias in this patient population. We present a 54-year-old white man treated in the burn intensive care unit for 70% TBSA burns. The patient developed an acute increase in liver enzymes within days of starting intravenous amiodarone for the control of atrial fibrillation. A full radiologic hepatobiliary investigation did not reveal a source for hepatotoxicity. Discontinuation of amiodarone resulted in a rapid decrease in liver enzyme levels to baseline values. It is important to identify amiodarone as a potential cause of severe hepatotoxicity in burn patients, despite short duration of use and a low cumulative dose.
Maker
Ajay V
AV
Department of Surgery, Burn Center, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Orgill
Dennis P
DP
D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000209:etiology*; D002056:Burns / Q000150:complications* / Q000628:therapy; D056486:Chemical and Drug Induced Liver Injury; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000628:therapy; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone