AMIODARONE-ASSOCIATED GRANULOMA IN BONE-MARROW

BACKGROUND;: Amiodarone hydrochloride is classified as a Vaughan Willi ams class III antiarrhythmic agent, although class I, II, and IV effec ts may contribute to its favorable antiarrhythmic profile. It is assoc iated with a wide variety of adverse effects, such as hypothyroidism, hyperthyroidism, interstitial pulmonary disease, hepatitis, coagulatio n disorders, skin photosensitivity, corneal microdeposits, alopecia, p eripheral neuropathy, and cardiovascular arrhythmias. SUBJECTS: Bone m arrow aspirations and biopsies were performed on two patients treated with amiodarone, on the first during a follow-up for myelofibrosis and on the second for a suspected lymphoproliferative disorder, Several b one marrow granulomas were found in both patients. The bone marrow spe cimens for tuberculosis and fungal stains were negative. CONCLUSIONS: The temporal relationship between the amiodarone therapy and the devel opment of two cases of asymptomatic bone marrow granuloma suggest the possibility that this antiarrhythmic agent is involved in the etiology of these granulomas.