Amiodarone-induced hepatitis and polyneuropathy.
Amiodarone chlorhydrate is a diiodated benzofuran derivative, and it is used to treat cardiac rhythm abnormalities. Hepatotoxicity is a relatively uncommon side effect of amiodarone, and symptomatic hepatic dysfunction occurs in fewer than 1% of the patients taking amiodarone. Cirrhosis is a rare complication that's been confirmed in 12 cases. Peripheral neuropathy occurs in 10% of patients taking aminodarone. We report here on an unusual case of amiodarone-induced hepatotoxicity and peripheral neurotoxicity. A 75 year old man with normal liver function was given amiodarone for treating his atrial fibrillation and heart failure. He developed nausea, vomiting, muscle weakness and wasting after 17.8 months therapy with amiodarone (400 mg orally once per day). Liver biopsy showed the presence of foam cells in the hepatic sinusoids and Mallory bodies in the periportal hepatocytes on light microscopy. Sural nerve biopsy showed demyelination, and nerve conduction studies showed mixed sensorimotor polyneuropathy. These observations show the necessity of monitoring the hepatic function and conducting neurologic examination of the patients treated with amiodarone.
Kang
Hyun Mo
HM
Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
Kang
Yoon Sae
YS
Kim
Seok Hyun
SH
Seong
Jae Kyu
JK
Kang
Dae Young
DY
Lee
Heon Young
HY
Lee
Byung Seok
BS
D000368:Aged; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000139:chemically induced; D008297:Male; D011115:Polyneuropathies / Q000139:chemically induced*
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone