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      Amiodarone-Induced Epididymitis: A Pathologically Confirmed Case Report and Review of the Literature

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          Abstract

          We report a case of amiodarone-induced epididymitis and review the pertinent literature. This disease is currently a diagnosis of exclusion and is believed to be self-limiting. We found new evidence for the pathological diagnosis and identified amiodarone-like crystals in the epididymis as a pathological mechanism of this disease. This case also suggests that amiodarone-induced epididymitis is not self-limiting. Continued use of amiodarone according to the current guidelines led to a bilateral epididymectomy. We recommend withdrawal or reduction of amiodarone dosage immediately once the signs and symptoms of epididymitis present in this population of patients. When epididymitis does not seem to be caused by an infection or any other identifiable etiology, this should not be overlooked by the cardiologist, urologist or general practitioner. These findings and recommendations should help reduce the suffering of patients and improve their clinical outcomes.

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          A practical guide for clinicians who treat patients with amiodarone: 2007.

          Nora Goldschlager, Andrew E Epstein, Gerald Naccarelli … (2007)
          Amiodarone is commonly used to treat supraventricular and ventricular arrhythmias in various inpatient and outpatient settings. Over- and under-use of amiodarone is common, and data regarding patterns of use are sparse and largely anecdotal. Because of adverse drug reactions, proper use is essential to deriving optimal benefits from the drug with the least risk. This guide updates an earlier version published in 2000, reviews indications for use of amiodarone and recommends strategies to minimize adverse effects. The recommendations included herein are based on the best available data and the collective experience of the member of the writing committee.
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            Practical Guidelines for Clinicians Who Treat Patients With Amiodarone

            Nora Goldschlager (2000)
            Article 0 comments Cited 9 times – based on 0 reviews     Review now
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              Amiodarone-induced epididymitis: a case report and review of the literature.

              Ignatios Ikonomidis, Ioannis Lekakis, Dimitrios Kremastinos … (2007)
              Epididymitis, as an unusual side-effect of amiodarone use, in a patient with dilated cardiomyopathy is reported along with a pertinent literature review. The diagnosis was one of exclusion after the patient received several regimens of antimicrobials and was only established after a dose reduction of the amiodarone regimen. Cardiologists should be aware of this rare but existing side effect of amiodarone, in order promptly intervene with dose adjustment or discontinuation of amiodarone and to avoid prolonged use of unnecessary antimicrobial regimens.
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                Author and article information

                Journal
                Journal ID (publisher-id): CRD
                Journal ID (nlm-ta): Cardiology
                Journal ID (doi): 10.1159/issn.0008-6312
                Title: Cardiology
                Publisher: S. Karger AG
                ISSN (Print): 0008-6312
                ISSN (Electronic): 1421-9751
                Publication date Subscription-year: 2014
                Publication date (Print): July 2014
                Publication date (Electronic): 18 June 2014
                Volume: 128
                Issue: 4
                Pages: 349-351
                Affiliations
                aKey Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health; Department of Cardiology, Qilu Hospital, Shandong University, Jinan, and Departments of bHealth and cPathology, Qingdao Municipal Hospital, Qingdao, China; dDepartments of Pain Management and Neurosciences, Cleveland Clinic, Cleveland, Ohio, USA
                Author notes
                *Peili Bu, MD, Department of Cardiology, Qilu Hospital, Shandong University, 44 Wenhua Xi Road, Jinan 250012 (China), E-Mail peili_bu@163.com
                Author information
                https://orcid.org/0000-0002-6153-6576
                https://orcid.org/0000-0003-2064-6450
                Article
                Publisher ID: 361038 Other ID: Cardiology 2014;128:349-351
                DOI: 10.1159/000361038
                PubMed ID: 24942374
                SO-VID: 6b5074de-98c3-4895-9091-f7424f2ed943
                Copyright © © 2014 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 18 February 2014
                Date accepted : 28 February 2014
                Page count
                Figures: 2, Pages: 3
                Categories
                Subject: Novel Insights from Clinical Experience

                ScienceOpen disciplines: General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
                Keywords: Adverse effects,Drug-induced epididymitis,Amiodarone
                Data availability:
                ScienceOpen disciplines: General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology
                Keywords: Adverse effects, Drug-induced epididymitis, Amiodarone

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