Amiodarone deposition in the liver

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Complain of bilateral chest pain & backache for 1 week after a history of fall down in the bathroom.

Patient Data

Age: 80 years
Gender: Female
  • Multiple recent bilateral rib fractures (non-displaced fractures of the right posterolateral 6th, 7th, 8th, & 9th ribs and fractured left 9th & 11th ribs close to the costovertebral junction) and old/healed fracture of the left 2nd rib anteriorly.
  • Fractured right transverse processes of the 6th, 7th, 8th, & 9th vertebrae.
  • Diffuse osteopenia, dorsal spondylosis, and a superior endplate compression fracture of the 11th dorsal vertebra without any retropulsion.
  • Mild cardiomegaly. Evidence of previous sternotomy/cardiac surgery/valve replacement is noted.
  • Mild bilateral pleural effusions with changes of collapse/atelectasis in the underlying lungs.
  • Small hyperdense focus measuring 7 x 9 mm (average density=950 HU) at the gastroesophageal junction (patient took some tablets just before the CT scan).
  • Incidental finding of increased hepatic attenuation (average density=84 HU). 

Case Discussion

  • Detailed history: Hypertension, rheumatic heart disease, atrial fibrillation & ventricular tachycardia.
  • Multiple cardiac surgeries (CABG, mitral valve replacement, tricuspid valve repair, and PFO closure).
  • Drugs (atenolol, amiodarone, digoxin, and warfarin).
  • Increased hepatic attenuation, was an incidental finding, in this case, which was likely one of the complications/side effects related to the amiodarone therapy (Amiodarone deposition in the liver).

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