Tun Myo Myint, Pandey Sagar, Adhikari Samaj, Mainali Arjun, Thapa Ashish, Bisural Roshan, Bista Puspa B, Htet Shwe Yee, Chhetri Bhawana, Panigrahi Kalpana
Internal Medicine, One Brooklyn Health - Interfaith Medical Center, Brooklyn, USA.
Internal Medicine, Nepal Medical College Teaching Hospital, Kathmandu, NPL.
Cureus. 2023 Jun 1;15(6):e39844. doi: 10.7759/cureus.39844. eCollection 2023 Jun.
Amiodarone, a class III antiarrhythmic drug, is commonly used for the management of life-threatening ventricular arrhythmias, atrial fibrillation, and other refractory supra-ventricular arrhythmias. Factors like a large volume of distribution, lipophilic property, deposition in tissues in large amounts, etc. have led to the development of amiodarone-induced multisystem adverse events. We report a case of amiodarone-induced hepatic attenuation on computed tomography (CT) of the abdomen in an elderly female patient. Amiodarone with a composition of 40% iodine by weight deposits in the liver, leading to characteristically increased radiodensity reported as increased attenuation on CT scan. Surprisingly, the severity and extent of hepatic attenuation on CT scans do not necessarily correlate with the total exposure to amiodarone over time. Individual factors may influence the liver's response to the drug, leading to varying degrees of hepatic changes. To minimize the risk of adverse events associated with amiodarone, clinicians should carefully adjust the dosage to the lowest effective level and regularly monitor liver function tests in patients. This proactive approach enables early detection of liver dysfunction and facilitates timely adjustments or discontinuation of amiodarone, thereby reducing potential harm.
胺碘酮是一种Ⅲ类抗心律失常药物，常用于治疗危及生命的室性心律失常、心房颤动及其他难治性室上性心律失常。胺碘酮具有分布容积大、亲脂性、大量沉积于组织等特性，导致了胺碘酮诱发的多系统不良事件。我们报告一例老年女性患者腹部计算机断层扫描（CT）显示胺碘酮诱发肝脏密度增高的病例。胺碘酮含40%（重量）的碘，沉积于肝脏，导致CT扫描显示特征性的放射性密度增加，即密度增高。令人惊讶的是，CT扫描上肝脏密度增高的严重程度和范围不一定与随时间累积的胺碘酮总暴露量相关。个体因素可能影响肝脏对该药物的反应，导致不同程度的肝脏改变。为将胺碘酮相关不良事件的风险降至最低，临床医生应谨慎地将剂量调整至最低有效水平，并定期监测患者的肝功能检查。这种积极主动的方法能够早期发现肝功能障碍，并有助于及时调整或停用胺碘酮，从而减少潜在危害。
