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Amiodarone-induced liver injury with bright liver sign: A case report
Zheng-Qing Shen, Xiao-Xiao Xia, Die-Wen Dong, Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Xiao-Xiao Xia, Department of Endocrinology & Metabolism, Zhejiang Medical & Health Group Hangzhou Hospital, Hangzhou 310000, Zhejiang Province, China
Xian-Feng Zhang, Department of Endocrinology & Metabolism, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310006, Zhejiang Province, China
Nan-Jing Shi, Department of Endocrinology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310006, Zhejiang Province, China
Co-first authors: Zheng-Qing Shen and Xiao-Xiao Xia.
Co-corresponding authors: Xian-Feng Zhang and Nan-Jing Shi.
Author contributions: Shen ZQ contributed to manuscript writing and editing; Xia XX contributed to case collection; Dong DW contributed to image reading; Zhang XF contributed to guidance and supervision; Shi NJ contributed to project support and final manuscript review; and all authors have read and approved the final manuscript. Zhang XF and Shi NJ served as co-corresponding authors and played indispensable roles in guiding the diagnosis and treatment of the case and in reviewing and revising the manuscript. Zhang XF supervised and coordinated the entire project, provided comprehensive guidance on the diagnosis, treatment, and follow-up of the case, confirmed the diagnosis of amiodarone-induced liver injury, and led the team in completing a thorough differential diagnosis; in addition, Zhang XF critically reviewed the manuscript and provided key revisions. Shi NJ provided financial support for the project, performed a systematic literature search and review, highlighted the rarity and clinical features of amiodarone-induced liver injury in the manuscript, completed the comprehensive review and revision of the manuscript, and was responsible for the final approval of the submitted version. The close collaboration between Zhang XF and Shi NJ was crucial for the successful publication of this paper.
AI contribution statement: Portions of this manuscript were translated with the assistance of DeepL. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by the Construction Fund of Key Medical Disciplines of Hangzhou, Clinical Research and Evaluation, No. 2025HZGF04.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Nan-Jing Shi, Attending Physician, Department of Endocrinology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. 21618295@zju.edu.cn
Received: July 8, 2026
Revised: August 12, 2026
Accepted: September 20, 2026
Published online: September 28, 2026
Processing time: 85 Days and 15.4 Hours
Revised: August 12, 2026
Accepted: September 20, 2026
Published online: September 28, 2026
Processing time: 85 Days and 15.4 Hours
Core Tip
Core Tip: We report a case of amiodarone-induced hepatic iodine deposition and review the relevant literature to highlight the key distinguishing features between amiodarone-induced liver injury (AILI) and hemochromatosis. Although diffuse hepatic hyperattenuation on computed tomography can be easily misdiagnosed as hemochromatosis, a normal T2-weighted imaging (T2WI) signal on magnetic resonance imaging, in contrast to the diffuse hypointensity across all sequences typically observed in hemochromatosis, may aid in differential diagnosis. However, mildly decreased hepatic signal intensity on T2WI does not definitively exclude AILI. Normal serum iron parameters further support an accurate differential diagnosis.