Bratton Hunter, Alomari Mohammad, Al Momani Laith A, Aasen Tyler, Young Mark
Internal Medicine, East Tennessee State University, Johnson City, USA.
Internal Medicine, Fairview Hospital, Cleveland, USA.
Cureus. 2019 Jan 8;11(1):e3850. doi: 10.7759/cureus.3850.
Adverse reactions to the antiarrhythmic medication amiodarone are severe, potentially life-threatening, and not rare. One in three patients on long-term therapy experience elevated liver enzymes, and clinically apparent liver toxicity occurs in 1% of patients treated. We report the case of a 76-year-old patient with amiodarone-induced intrahepatic cholestasis and prolonged hyperbilirubinemia despite the discontinuation of the offending agent. Current research hypothesizes that amiodarone leads to hepatic injury both by direct hepatotoxicity and by increasing the likelihood of hepatocytes to create abnormal, toxic metabolites. Increased awareness of such an adverse effect can guide clinicians toward the possible underlying etiologies of prolonged jaundice.
抗心律失常药物胺碘酮的不良反应严重，可能危及生命，且并不罕见。接受长期治疗的患者中，三分之一会出现肝酶升高，1%接受治疗的患者会出现临床明显的肝毒性。我们报告了一例76岁患者的病例，该患者出现胺碘酮诱导的肝内胆汁淤积和尽管停用致病药物但仍持续存在的高胆红素血症。目前的研究推测，胺碘酮通过直接肝毒性以及增加肝细胞产生异常有毒代谢物的可能性导致肝损伤。提高对这种不良反应的认识可以指导临床医生了解长期黄疸可能的潜在病因。
