Amiodarone-Induced Acute Liver Injury

Essrani, Rajesh; Mehershahi, Shehriyar; Ravi, Shri Jai Kirshan; Bhura, Sajeer; Sudhakaran, Anuraj; Hossain, Muhammad Rajib; Mehmood, Asif

doi:10.1159/000506184

Cited by 6 publications

(10 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ischemic hepatitis is another cause of ALF, and can result from cardiac failure, sepsis, Budd-Chiari syndrome, or some drugs that have vasoconstricting properties like cocaine and methamphetamine [15]. ALF can be induced by amiodarone, the drug of choice for both supraventricular and ventricular arrythmias [1,11]. It is a class III antiarrhythmic that works predominantly by blocking potassium channels, which increases the cardiac action potential duration [16].…”

Section: Discussionmentioning

confidence: 99%

“…Acute liver failure (ALF) is defined as a loss of liver function characterized by encephalopathy, and elevation of liver enzymes and prothrombin time [ 1 ]. It is mainly caused by acetaminophen overdose, viral hepatitis, idiosyncratic drug reactions, or hypoperfusion of the liver [ 1 , 2 ]. Up to 30% of the patients die without liver transplantation [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic Oral Amiodarone as a Cause of Acute Liver Failure

et al. 2023

View full text Add to dashboard Cite

Acute liver failure (ALF) is a rare condition that can have a variable clinical course and potentially fatal outcomes. Medication toxicity is a known etiology, however liver failure induced by amiodarone is rare and has been reported mostly in the setting of intravenous (IV) infusion. We present an 84-year-old patient who developed ALF after chronic use of oral amiodarone. The patient received supportive care and her symptoms improved.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronic Oral Amiodarone as a Cause of Acute Liver Failure

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In our opinion, his clinical improvement was due to a combination of intensive care management, which included oxygen therapy, noninvasive ventilation, antibiotic therapy, diuretic and beta-blockers administration, pleurocentesis, and drug discontinuation. Intensive care measures, rather than amiodarone discontinuation led to clinical improvement because amiodarone is a lipophilic structure with a half-life of 25–100 days [ 24 ]. The aim of this case report was to emphasize that we should think about AIPT even in patients with no obvious risk or precipitating factors and taking only a low-dose of amiodarone.…”

Section: Discussionmentioning

confidence: 99%

Acute respiratory failure on a low dose of amiodarone – is it an underdiagnosed and undertreated condition?

Meter

Prusac

Glavaš

et al. 2021

Respiratory Medicine Case Reports

View full text Add to dashboard Cite

Amiodarone-induced pulmonary toxicity (AIPT) has a variety of presentations. Amiodarone use has been rarely associated with the development of acute respiratory failure. We present a patient with a history of paroxysmal atrial fibrillation who developed acute respiratory distress syndrome despite taking a low dose of amiodarone and having no risk or precipitating factors. The diagnosis of AIPT was made after drug discontinuation and exclusion of other potential causes. The development of acute respiratory failure due to AIPT is often underdiagnosed and undertreated. Better identification of risk factors and developing appropriate diagnostic tools for risk stratification of patients receiving amiodarone is mandatory.

show abstract

“…The drug is very lipophilic and is concentrated in adipose tissue, muscle, and thyroid. Interestingly, it has been found to induce ultrastructural changes in several organs, including the lung, thyroid, and liver, which correlates with its extensive side effect profile [ 43 – 45 ]. Furthermore, Smyrk et al demonstrated that the drug is taken up by thyroid follicular cells by direct measurement of thyroid tissue from a patient taking the drug [ 42 ].…”

Section: Cardiotropic Drugsmentioning

confidence: 99%

The Thyroid Pathologist Meets Therapeutic Pharmacology

2023

View full text Add to dashboard Cite

The effects of many pharmacological agents on thyroid function are well known. Direct influences on measurements of thyroid function tests are also described. However, certain classes of drugs produce morphological changes in the gland. This review focuses on the significance of the following drug classes for the thyroid pathologist: iodine, antithyroid drugs, psychotropic drugs, antibiotics, cardiotropic drugs, antidiabetic drugs, and immunomodulatory agents. Radioactive iodine initially induces mild histologic changes; however, the long-term effects include marked follicular atrophy, fibrosis, and nuclear atypia—changes that vary depending on the pre-therapy condition of the gland. Some psychotropic drugs have been associated with a spectrum of inflammatory changes throughout the gland. The tetracycline class of antibiotics, namely minocycline, can lead to a grossly black thyroid gland with pigment seen in both colloid and follicular epithelial cells while variably present within thyroid nodules. The surgical pathologist most commonly sees an amiodarone-affected gland removed for hyperthyroidism, and the histologic findings again depend on the pre-therapy condition of the gland. While GLP-1 receptor agonists carry an FDA black box warning for patients with a personal or family history of multiple endocrine neoplasia or medullary thyroid carcinoma, the C cell hyperplasia originally noted in rats has not borne out in human studies. Finally, thyroiditis and hypothyroidism are well known complications of checkpoint inhibitor therapy, and rare cases of severe thyroiditis requiring urgent thyroidectomy have been reported with unique histologic findings. In this review, we describe the histologic findings for these drugs and more, in many cases including their functional consequences.

show abstract

Amiodarone-Induced Acute Liver Injury

Cited by 6 publications

References 8 publications

Chronic Oral Amiodarone as a Cause of Acute Liver Failure

Chronic Oral Amiodarone as a Cause of Acute Liver Failure

Acute respiratory failure on a low dose of amiodarone – is it an underdiagnosed and undertreated condition?

The Thyroid Pathologist Meets Therapeutic Pharmacology

Contact Info

Product

Resources

About