{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:29:24Z","timestamp":1792801764749,"version":"4.5.0"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Amiodarone is an antiarrhythmic drug that has been recognized to induce hepatotoxicity. We report a case of acute-on-chronic liver failure (ACLF) in a patient who was receiving amiodarone for more than 2\u00a0years. The patient developed cirrhosis and suppurative microabscesses of the liver and died of progressive liver failure.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 69-year-old woman with risk factors for nonalcoholic fatty liver disease (NAFLD) was treated with oral amiodarone at a daily dose of 400\u00a0mg for more than 2\u00a0years, until she developed epigastralgia and vomiting. Initial laboratory findings included leukocytosis and elevated liver enzymes. Images of abdominal computed tomography scan revealed diffusely increased hepatic attenuation density (in contrast to decreased density in NAFLD), hepatomegaly, periportal edema, and ascites. Liver biopsy targeting the hotspot identified through positron emission tomography confirmed the diagnosis of amiodarone-associated chronic steatohepatitis and superimposed microabscesses. The patient died of progressive ACLF despite intensive supportive care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Accumulation of amiodarone can result in chronic liver disease and pose an additional risk of ACLF following infection.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-021-01632-9","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T13:13:44Z","timestamp":1612271624000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Fatal acute-on-chronic liver failure in amiodarone-related steatohepatitis: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"I.-J.u","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Huei","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1874-7615","authenticated-orcid":false,"given":"Cheng-Maw","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"issue":"3","key":"1632_CR1","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1136\/gutjnl-2016-312670","volume":"66","author":"R Hernaez","year":"2017","unstructured":"Hernaez R, Sol\u00e0 E, Moreau R, Gin\u00e8s P. Acute-on-chronic liver failure: an update. Gut. 2017;66(3):541\u201353.","journal-title":"Gut"},{"issue":"1","key":"1632_CR2","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1186\/s13054-018-2156-0","volume":"22","author":"C Engelmann","year":"2018","unstructured":"Engelmann C, Thomsen KL, Zakeri N, Sheikh M, Agarwal B, Jalan R, et al. Validation of CLIF-C ACLF score to define a threshold for futility of intensive care support for patients with acute-on-chronic liver failure. Crit Care. 2018;22(1):254.","journal-title":"Crit Care"},{"issue":"4","key":"1632_CR3","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1007\/s11096-018-0698-5","volume":"40","author":"JH Ye","year":"2018","unstructured":"Ye JH, Ho YF, On AW, Chen WW, Huang YM, Huang WI, et al. Trends in reporting drug-associated liver injuries in Taiwan: a focus on amiodarone. Int J Clin Pharm. 2018;40(4):911\u201320.","journal-title":"Int J Clin Pharm"},{"key":"1632_CR4","unstructured":"LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National institute of diabetes and digestive and kidney diseases; 2012-. Amiodarone. [Updated 2016 Mar 1]. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK548109\/"},{"key":"1632_CR5","doi-asserted-by":"publisher","first-page":"2948","DOI":"10.3389\/fimmu.2018.02948","volume":"9","author":"E Triantafyllou","year":"2018","unstructured":"Triantafyllou E, Woollard KJ, McPhail MJW, Antoniades CG, Possamai LA. The role of monocytes and macrophages in acute and acute-on-chronic liver failure. Front Immunol. 2018;9:2948.","journal-title":"Front Immunol"},{"issue":"1 Suppl","key":"1632_CR6","first-page":"86","volume":"21","author":"L Miele","year":"2017","unstructured":"Miele L, Liguori A, Marrone G, et al. Fatty liver and drugs: the two sides of the same coin. Eur Rev Med Pharmacol Sci. 2017;21(1 Suppl):86\u201394.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"1632_CR7","first-page":"617943","volume":"2013","author":"N Hussain","year":"2013","unstructured":"Hussain N, Bhattacharyya A, Prueksaritanond S. Amiodarone-induced cirrhosis of liver: what predicts mortality? ISRN Cardiol. 2013;2013:617943.","journal-title":"ISRN Cardiol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01632-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12876-021-01632-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01632-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T13:17:13Z","timestamp":1612271833000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-021-01632-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,2]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1632"],"URL":"https:\/\/doi.org\/10.1186\/s12876-021-01632-9","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,2]]},"assertion":[{"value":"9 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Waived.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent for publication from the next of kin was obtained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Nothing to report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"50"}}