Unexplained bone marrow granulomas: Is amiodarone the culprit? A report of 2 cases

Mukhopadhyay, Surabhi; Mukhopadhyay, Sanjay; Abraham, Naif Z.; Jones, Lee Anna; Howard, Leslie; Gajra, Ajeet

doi:10.1002/ajh.10465

Cited by 19 publications

(8 citation statements)

References 6 publications

(7 reference statements)

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“…7–13 In several reports, amiodarone was not stopped because the treating physicians determined that the cardiac benefits outweighed the potential hematologic risks. 9,11,12 Boutros et al 8 and Moran and Manoharan 10 observed an improvement in cytopenias that paralleled a partial or complete resolution of bone marrow granulomas by three to eight months after cessation of amiodarone. Mohamed et al 9 reported a patient with leukopenia and thrombocytopenia that improved by six months after discontinuation of amiodarone.…”

Section: Discussionmentioning

confidence: 94%

Amiodarone-Induced Bone Marrow Granulomas: An Unusual Cause of Reversible Pancytopenia

2010

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Bone marrow infiltration by granulomas rarely presents with cytopenias and is usually a result of atypical infections, lymphomas, or sarcoidosis. Drugs are also an important but often overlooked causal agent of bone marrow granulomas. Although rare, amiodarone has been associated with bone marrow granuloma formation. This case report describes a 73-year-old male who presented with pancytopenia during a preoperative evaluation. Amiodarone therapy was suspected to be the causal agent after diagnostic evaluation and exclusion of other causes. After cessation of amiodarone, the patient's pancytopenia gradually resolved over a period of several months. Our report illustrates an often overlooked yet important cause of reversible pancytopenia owing to suspected amiodarone-induced bone marrow granuloma formation, and guides clinicians in an expected timeline for blood count improvement after cessation of this drug.

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Section: Discussionmentioning

confidence: 94%

Amiodarone-Induced Bone Marrow Granulomas: An Unusual Cause of Reversible Pancytopenia

2010

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“…This was attributed to amiodarone induced bone marrow granuloma through inhibition of phospholipases, leading to accumulation of phospholipids in bone marrow (Lossos and Matzner 1992). (Mukhopadhyay et al; suggested that granuloma formation occur due to immunological reaction. Other author (Chang and Ng, 2008) suggested that amiodarone initiate (erythropoietin) EPO-resistant anemia after treatment for arrhythmia which consequently cause decrease in RBCs synthesis and anemia.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological studies on the remodeling effect of Platelet-Rich plasma on lung fibrosis induced by amiodarone in Albino rats

Maher¹,

Elsayied²,

El-Din³

2020

VMPH

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Objectives: This study aimed to evaluate the role of platelet rich plasma (PRP) in the treatment of lung fibrosis induced by amiodarone drug. Materials and Methods: Seventy adult male Wistar albino rats were divided into three groups (n=20) plus ten rats were used for PRP collection. The first group used as control group. The rats in second group (gp.2) were injected intraperitoneally (i.p.) daily with amiodarone drug at (80 mg/ kg. bwt) for three weeks, then injected (24 hours after last dose of amiodarone) (i.p.) with phosphate buffer saline (PBS) (0.5 ml/ kg. bwt) two times weekly for three weeks. The rats in third group (gp.3) were injected (i.p.) daily with amiodarone drug at (80 mg/ kg. bwt) for three weeks, plus (i.p.) injection with platelet rich plasma (PRP) at dose (0.5 ml/kg. bwt) (24 hours after last dose of amiodarone injection) two times weekly for three weeks. The animals were examined during the experiment and sacrificed at the end of the experiment. Results: Rats in the PRP treatment (gp. 3) showed an increase in the level of WBCs and RBCs counts in comparison with group 2. Significant increase in glutathione reductase and a significant decrease in malondialdehyde levels were detected in group 3 when compared with group 2. The histopathological findings showed an improvement in the fibrosed lungs compared to gp (2). Conclusions: This study concluded the remodeling effect of PRP, which was observed clinically and pathologically against the harmful effects of amiodarone in albino rats.

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“…Granulomatous bone marrow reactions have also been described in hematological malignancies, especially in Hodgkin and non-Hodgkin lymphomas but it is not clear if these findings are related to malignancy or infections (Table 1). [14][15][16]…”

Section: Discussionmentioning

confidence: 99%

Bone marrow granulomatosis: two case reports

et al. 2019

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Bone marrow granulomatosis is not a common finding and remains a diagnostic challenge. Here below we report two bizarre but not so rare cases of bone marrow granulomatosis: bone marrow involvement by Mycobacterium avium-intracellulare and reaction to intravesical administration of Bacillus Calmette-Guérin for non-muscle-invasive bladder cancer; two distinct culprits suggesting the wide range of possible causative factors of this histopathological pattern. In the discussion we provide a brief overview of causes and suggestions for a diagnostic approach.

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Unexplained bone marrow granulomas: Is amiodarone the culprit? A report of 2 cases

Cited by 19 publications

References 6 publications

Amiodarone-Induced Bone Marrow Granulomas: An Unusual Cause of Reversible Pancytopenia

Amiodarone-Induced Bone Marrow Granulomas: An Unusual Cause of Reversible Pancytopenia

Clinicopathological studies on the remodeling effect of Platelet-Rich plasma on lung fibrosis induced by amiodarone in Albino rats

Bone marrow granulomatosis: two case reports

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