Lupon-Rosés J, Simó-Canonge R, Lu-Cortez L, Permanyer-Miralda G, Allende-Monclús H
Clin Cardiol. 1986 May;9(5):223-5. doi: 10.1002/clc.4960090512.
A patient with acute changes suggesting acute hepatitis after parenteral amiodarone administration is described. A 77-year-old man with previous myocardial infarction was admitted with chronic left heart failure and atrial tachycardia. Initial hepatic function tests were strictly normal. After therapy with parenteral amiodarone (2300 mg in 3 days) and other measures, signs of congestive heart failure disappeared; subsequently the patient developed jaundice, marked increase in serum transaminase levels and fall in prothrombin time, and histologic changes of severe centrilobular necrosis were observed in hepatic biopsy. Clinical, laboratory (absence of others markers of hepatic disease), and histological findings seem to rule out common causes of hepatic disease. Therefore, parenteral amiodarone was implicated as the cause of acute hepatitis in this patient. In addition, there were findings suggesting a possibly immunologically mediated mechanism.
本文描述了一例在静脉注射胺碘酮后出现提示急性肝炎的急性变化的患者。一名曾患心肌梗死的77岁男性因慢性左心衰竭和房性心动过速入院。初始肝功能检查完全正常。在静脉注射胺碘酮（3天内共2300毫克）及采取其他措施治疗后，充血性心力衰竭的体征消失；随后患者出现黄疸、血清转氨酶水平显著升高以及凝血酶原时间下降，肝脏活检显示严重的小叶中心坏死的组织学改变。临床、实验室检查（无其他肝病标志物）及组织学检查结果似乎排除了常见的肝病病因。因此，静脉注射胺碘酮被认为是该患者急性肝炎的病因。此外，有证据提示可能存在免疫介导机制。
