Thursday 24 February 2005
Definition: Amiodarone is a potent antiarrhythmic agent.
The majority of cases display liver enzyme abnormalities within 24 h of intravenous infusion.
Even low oral dosing (200 mg daily) may trigger steatohepatitis with cumulative use.
Amiodarone steatohepatitis is characterised by prominent Mallory hyaline (occasionally in zone 1) and neutrophilic satellitosis, while steatosis is less conspicuous.
The findings can be similar to alcoholic steatohepatitis. Reversal of liver injury often occurs with discontinuation of the drug but may be delayed by weeks or months.
Phospholipidosis is not always seen in amiodarone toxicity and is independent of steatohepatitis.
Lymphoid Hyperplasia and Eosinophilic Pneumonia as Histologic Manifestations of Amiodarone-induced Lung Toxicity. Larsen BT, Vaszar LT, Colby TV, Tazelaar HD. Am J Surg Pathol. 2012 Feb 3. PMID: 22314187
Lewis JH, Mullick F, Ishak KG, Ranard RC, Ragsdale B, Perse RM, Rusnock EJ, Wolke A, Benjamin SB, Seeff LB, et al. Histopathologic analysis of suspected amiodarone hepatotoxicity. Hum Pathol. 1990 Jan;21(1):59-67. PMID: 2403975