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An 88-year-old woman presented with a 5-day history of nausea, vomiting and abdominal pain at the emergency department. Her medical history included sick sinus syndrome and atrial flutter, for which she underwent permanent pacemaker implantation and radiofrequency catheter ablation 4 and 6 months earlier, respectively. She had been prescribed amiodarone for 5 months (600 mg/day for 2 months, then 400 mg/day for 3 months) due to relapsing atrial flutter after ablation. The level of alanine aminotransferase was 45 U/L (reference range, 0–41), total bilirubin was 0.66 mg/dL (reference range, 0.3–1.0) and direct …
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