TY - JOUR
T1 - Amiodarone-associated bone marrow granulomas
T2 - A report of 2 cases and review of the literature
AU - Mohamed, Tarek
AU - Sanjay, Rashmi
AU - Sycheva, Tatyana
AU - Aish, Leo
AU - Schneider, Douglas
AU - Oo, Thein H.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/2
Y1 - 2007/2
N2 - Amiodarone therapy is associated with several adverse effects, including hematologic ones such as pancytopenia, hemolytic anemia, and aplastic anemia. Very few cases of amiodarone-associated bone marrow granulomas have been reported. We report 2 cases of amiodarone-associated bone marrow granulomas. Patient 1 was an 81-year-old man who presented with leukopenia, thrombocytopenia, and hepatosplenomegaly after 2 years of amiodarone therapy. Patient 2 was an 80-year-old man who presented with pancytopenia 2 1/2 years after starting amiodarone treatment. Both patients had normal blood counts before amiodarone therapy. Bone marrow biopsies showed noncaseating granulomas in both patients. We reviewed the literature available on Medline for amiodarone-associated bone marrow granulomas and found 8 reported cases of amiodarone-associated bone marrow granulomas. One case also featured amiodarone-associated hepatic granulomas. Amiodarone therapy was stopped in 5 cases, with improvement of the granulomas occurring in 3 cases. We conclude that bone marrow granulomas, although rare, should be considered as a differential diagnosis for patients undergoing amiodarone therapy and presenting with cytopenias.
AB - Amiodarone therapy is associated with several adverse effects, including hematologic ones such as pancytopenia, hemolytic anemia, and aplastic anemia. Very few cases of amiodarone-associated bone marrow granulomas have been reported. We report 2 cases of amiodarone-associated bone marrow granulomas. Patient 1 was an 81-year-old man who presented with leukopenia, thrombocytopenia, and hepatosplenomegaly after 2 years of amiodarone therapy. Patient 2 was an 80-year-old man who presented with pancytopenia 2 1/2 years after starting amiodarone treatment. Both patients had normal blood counts before amiodarone therapy. Bone marrow biopsies showed noncaseating granulomas in both patients. We reviewed the literature available on Medline for amiodarone-associated bone marrow granulomas and found 8 reported cases of amiodarone-associated bone marrow granulomas. One case also featured amiodarone-associated hepatic granulomas. Amiodarone therapy was stopped in 5 cases, with improvement of the granulomas occurring in 3 cases. We conclude that bone marrow granulomas, although rare, should be considered as a differential diagnosis for patients undergoing amiodarone therapy and presenting with cytopenias.
KW - Amiodarone
KW - Bone marrow granulomas
KW - Cytopenias
UR - http://www.scopus.com/inward/record.url?scp=33847634899&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33847634899&partnerID=8YFLogxK
U2 - 10.1532/IJH97.NA0608
DO - 10.1532/IJH97.NA0608
M3 - Review article
C2 - 17321985
AN - SCOPUS:33847634899
SN - 0925-5710
VL - 85
SP - 101
EP - 104
JO - International journal of hematology
JF - International journal of hematology
IS - 2
ER -