Journal
WORLD JOURNAL OF CLINICAL CASES
Volume 8, Issue 20, Pages 4958-4965Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.12998/wjcc.v8.i20.4958
Keywords
Case report; Amiodarone; Hepatotoxicity; Iodine density; Computed tomography; Dual energy; Arrhythmias
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Funding
- Science and Technology Bureau of Jiaxing, Zhejiang Province of China [2017BY18018]
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BACKGROUND Amiodarone is the drug most commonly used to manage arrhythmias. Long-term amiodarone administration causes hepatotoxicity due to iodine accumulation in the liver. Here, we present three cases of amiodarone-induced hepatotoxicity in patients on long-term oral amiodarone therapy who underwent dual-energy computed tomography (DECT). CASE SUMMARY We report the clinical and iodine density in the liver using DECT in three patients with amiodarone-induced hepatotoxicity. Liver enzymes were increased in these three patients, and abdominal DECT without contrast medium showed highly increased attenuation in the liver. Furthermore, the iodine concentration in the liver was increased. The first patient with amiodarone-induced reversible hepatotoxicity, showed a reversible course of liver function and a decrease in CT values after discontinuation of amiodarone. The second patient on long-term oral amiodarone had increased iodine concentration in the liver and liver damage, the patient eventually developed rapidly progressive pneumonia and died of multiple organ failure. The third patient, showed an increased iodine concentration in the liver and elevated liver enzymes. However, the patient refused radiofrequency ablation for atrial fibrillation and continued oral amiodarone to control atrial fibrillation, and routine liver function tests were required every 3-6 mo in this patient. CONCLUSION DECT is a potentially noninvasive diagnostic tool for quantifying iodine concentration in the liver and monitoring adverse reactions due to amiodarone.
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