Mudalel ML, Dave KP, Hummel JP, Solga SF. N-acetylcysteine treats intravenous amiodarone induced liver injury. World J Gastroenterol 2015; 21(9): 2816-2819 [PMID: 25759554 DOI: 10.3748/wjg.v21.i9.2816]
Corresponding Author of This Article
Steven F Solga, MD, Chief of Gastroenterology, Department of Medicine, Division of Gastroenteorlogy, St. Luke’s University Hospital and Temple School of Medicine, 701 Ostrum St. Suite 604A, Bethlehem, PA 18015, United States. stevesolga@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Matthew L Mudalel, Kartikeya P Dave, James P Hummel, Steven F Solga
Matthew L Mudalel, Steven F Solga, Department of Medicine, Division of Gastroenteorlogy, St. Luke’s University Hospital and Temple School of Medicine, Bethlehem, PA 18015, United States
Kartikeya P Dave, Department of Medicine, Montefiore Medical Center, Bronx, NY 10461, United States
James P Hummel, Department of Medicine, Division of Cardiology, University of North Carolina, Chapel Hill, NC 27514, United States
Author contributions: Mudalel ML, Dave KP, Hummel JP and Solga SF co-wrote manuscript, edited manuscript, produced illustrations; Hummel JP and Solga SF interpreted data.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Steven F Solga, MD, Chief of Gastroenterology, Department of Medicine, Division of Gastroenteorlogy, St. Luke’s University Hospital and Temple School of Medicine, 701 Ostrum St. Suite 604A, Bethlehem, PA 18015, United States. stevesolga@gmail.com
Telephone: +1-610-8663900 Fax: +1-610-8668140
Received: April 16, 2014 Peer-review started: April 16, 2014 First decision: May 13, 2014 Revised: October 7, 2014 Accepted: November 18, 2014 Article in press: November 19, 2014 Published online: March 7, 2015 Processing time: 327 Days and 12 Hours
Abstract
We report a case of intravenous (IV) amiodarone drug induced liver injury (DILI). The patient received IV N-acetylcysteine (NAC) which resulted in a rapid improvement in liver enzymes. While the specific mechanisms for the pathogenesis of IV amiodarone DILI and the therapeutic action of IV NAC are both unknown, this case strongly implies at least some commonality. Because IV amiodarone is indicated for the treatment of serious cardiac arrhythmias in an intensive care unit setting, some degree of ischemic hepatitis is likely a cofactor in most cases.
Core tip: Intravenous (IV) amiodarone drug induced liver injury (DILI) is uncommon, and difficult to distinguish from ischemic hepatitis or congestive hepatopathy. Further, the pathophysiology is uncertain. IV N-acetylcysteine (NAC) is often used empirically as a treatment for idiopathic hepatitis or DILI. We report a case of rapid improvement of liver enzymes in a suspected case of IV amiodarone DILI with IV NAC, suggesting at least some shared features between the pathogenic mechanisms of the former and the therapeutic actions of the latter.
