Hyperglobulinemia in amiodarone-induced pneumonitis

Background: Amiodarone is a very effective antiarrhytmic drug. However its use may be accompanied by side effects. Hyperglobulinemia was not described in association with amiodarone treatment. Materials and methods: Fifteen patients, who developed hyperglobulinemia while on amiodarone therapy, were identified among the patients hospitalized in our hospital. Serum globulin concentration was measured prior to, during and after amiodarone therapy. Results: In 11 of the 15 patients with amiodarone-associated hyperglobulinemia, amiodarone treatment had to be stopped because of amiodarone-induced complications, nine of them had pneumonitis. Mean serum globulin level rose during amiodarone therapy from 2.48 ± 0.51 g/dL to 4.11 ± 0.71 g/dL (p = 0.001), and declined after it was stopped to 2.80 ± 0.49 g/dL (p = 0.001). In 50 patients treated by amiodarone, serum globulin was similar to that found in 50 patients with ischemic heart disease not treated by amiodarone [2.64 ± 0.39 g/dL and 2.56 ± 0.29 g/dL respectively (p = 0.21)]. Conclusions: In some patients amiodarone therapy may be associated with hyperglobulinemia. The incidence of this association is not known. Most of the patients with amiodarone-associated hyperglobulinemia have amiodarone-induced toxicity, mainly pneumonitis. Amiodarone therapy does not cause a general increase in serum globulins. Hyperglobulinemia may be a marker for a damaged organ, or it may have a pathogenetic role in the induction of pneumonitis.