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아미오다론 투여 후 동시에 발병된 간염과 갑상선 기능저하증
조영심 ( Young Shim Cho ),한정호 ( Joung Ho Han ),채희복 ( Hee Bok Chae ),김재수 ( Jae Su Kim ),강기만 ( Ky Man Kang ),박상민 ( Sang Min Park ),임준철 ( Jun Cheol Lim ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.1
Amiodarone is a di-iodated benzofuran derivative that is commonly used to treat patients with various cardiac arrhythmias. It is associated with side effects that involve the liver, thyroid, and other organs. Approximately 1-3% of patients treated with amiodarone suffer from symptomatic liver disease. Thyroid dysfunction occurs in 10% of patients treated with amiodarone. A 65-year-old woman with coronary heart disease and atrial fibrillation was administered with amiodarone. She developed nausea, vomiting, dyspepsia, and sweating within 9 months of amiodarone administration (200 mg orally once a day). Results of the laboratory finding showed increased hepatic enzymes, and low thyroid hormone levels. A liver biopsy showed irregular arrangement of hepatocytes and diffuse micro- and macrovesicular fatty changes. Electron microscopy findings showed pleomorphic mitochondria with crystalloid inclusions and membrane-bound lysosomal structures. The liver and thyroid functions returned to normal, after the amiodarone was stopped. We describe an unusual case in which amiodarone induced hepatitis and hypothyroidism simultaneously. Physicians should take a close look to the adverse event when using amiodarone which can cause adverse effects in multiple organs. (Korean J Gastroenterol 2013; 62:59-63)