Title:Intravenous Amiodarone-induced Acute Liver Failure: A Case Report and
Literature Review
Volume: 4
Author(s): Yara Bteich, Jad Hosri, Nagi Nauphal and Nour Ibrahim*
Affiliation:
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
Keywords:
Hepatotoxicity, Amiodarone, Drug-induced, Severe acute liver injury, Case report, Toxicity.
Abstract:
Background:
Hepatotoxicity of amiodarone has long been described and consists mostly of mild and delayed onset elevation in liver function tests. Fulminant
hepatitis, however, is much rarer and attributed to the parenteral administration of the drug. The mechanism of injury is yet to be understood,
though multiple theories have been proposed. This case report aims at highlighting the importance of monitoring patients receiving intravenous
amiodarone therapy to detect severe acute liver injury and showcase the appropriate management thereafter.
Case Description:
Our patient is a 79-year-old male who presented with epigastric pain that was crampy, intermittent, and aggravated upon exertion. His heart rate
was 93 beats/min and cardiac auscultation revealed an irregular heart rhythm. His electrocardiogram revealed atrial fibrillation. He was given
intravenous amiodarone with a total dose of 950 mg and developed acute liver failure with extremely elevated liver function tests 48 hours after
initiating the drug. After discontinuation, liver function tests returned to baseline within 10 days and the patient was discharged home.
Conclusion:
Physicians should be aware of the potentially life-threatening complications, including severe acute liver injury, by closely monitoring liver
function tests following the administration of the drug and immediately discontinuing therapy if toxicity was detected.
