TY - JOUR
T1 - Severe acute hepatitis following intravenous amiodarone
T2 - A case report and review of the literature
AU - Stratton, Amy
AU - Fenderson, Joshua
AU - Kenny, Patrick
AU - Helman, Donald Lee
N1 - Publisher Copyright:
© 2015, Universa Press.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Background and Aims : Hepatotoxic complications of long-term oral amiodarone therapy have been well described ; however, liver injury secondary to parenteral infusion of amiodarone is uncommon, potentially fatal, and poorly understood. The hepatotoxicity is thought to result from the diluent polysorbate 80 and not the amiodarone its self. Theories suggest an allergic or immunologic response leading to alterations in the hepatocellular membrane while some propose that ischemia, not a drug reaction, is truly to blame. Methods : Both the PubMed and Embase databases were searched for cases of acute hepatitis implicating intravenous amiodarone with a total of 25 cases from 1986 to 2012 identified. Each case was then carefully evaluated to determine the connection between parenteral amiodarone and acute hepatotoxicity while assessing for evidence of potential ischemia. Results : Of the 25 published cases of amiodarone induced acute hepatotoxicity available for review, only 10 provide evidence to conclusively implicate parenteral amiodarone as the etiology. We add the eleventh reported case of parenteral amiodarone induced acute severe hepatitis to the literature and report the most comprehensive review of this topic to date. Conclusion : There is sufficient evidence to support amiodarone induced acute hepatotoxicity as a unique entity separate from ischemic hepatitis. If suspected, parenteral amiodarone should be discontinued and held indefinitely.
AB - Background and Aims : Hepatotoxic complications of long-term oral amiodarone therapy have been well described ; however, liver injury secondary to parenteral infusion of amiodarone is uncommon, potentially fatal, and poorly understood. The hepatotoxicity is thought to result from the diluent polysorbate 80 and not the amiodarone its self. Theories suggest an allergic or immunologic response leading to alterations in the hepatocellular membrane while some propose that ischemia, not a drug reaction, is truly to blame. Methods : Both the PubMed and Embase databases were searched for cases of acute hepatitis implicating intravenous amiodarone with a total of 25 cases from 1986 to 2012 identified. Each case was then carefully evaluated to determine the connection between parenteral amiodarone and acute hepatotoxicity while assessing for evidence of potential ischemia. Results : Of the 25 published cases of amiodarone induced acute hepatotoxicity available for review, only 10 provide evidence to conclusively implicate parenteral amiodarone as the etiology. We add the eleventh reported case of parenteral amiodarone induced acute severe hepatitis to the literature and report the most comprehensive review of this topic to date. Conclusion : There is sufficient evidence to support amiodarone induced acute hepatotoxicity as a unique entity separate from ischemic hepatitis. If suspected, parenteral amiodarone should be discontinued and held indefinitely.
KW - Amiodarone hepatitis
KW - Amiodarone hepatotoxicity
KW - Polysorbate 80
KW - Severe acute hepatitis
UR - http://www.scopus.com/inward/record.url?scp=84936758269&partnerID=8YFLogxK
M3 - Article
C2 - 26151694
AN - SCOPUS:84936758269
SN - 1784-3227
VL - 78
SP - 233
EP - 239
JO - Acta Gastro-Enterologica Belgica
JF - Acta Gastro-Enterologica Belgica
IS - 2
ER -