Drug-induced steatohepatitis leading to cirrhosis: Long-term toxicity of amiodarone use

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Abstract

Nonalcoholic steatosis/steatohepatitis is the most common cause for abnormal liver chemistries. Apart from metabolic syndrome, drugs may also lead to development of steatohepatitis that may, rarely, progress to cirrhosis and portal hypertension. We discuss a case of amiodarone-induced steatohepatitis with advanced fibrosis, presenting with hepatic decompensation and portal hypertension manifesting as ascites and recurrent esophageal variceal hemorrhage. Amiodarone is a lipophilic drug that concentrates in the liver and usually, over a period of time, leads to toxicity related to drug accumulation. There is marked histological similarity between amiodarone-induced liver disease and alcoholic and nonalcoholic steatohepatitis. The clinical manifestations of amiodarone-induced hepatotoxicity and the mechanism of toxicity are also discussed.

Original languageEnglish
Pages (from-to)423-428
Number of pages6
JournalSeminars in Liver Disease
Volume29
Issue number4
DOIs
StatePublished - 2009

Keywords

  • Amiodarone
  • Cirrhosis
  • Hepatotoxicity
  • Phospholipidosis
  • Steatohepatitis

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