Abstract
A 70-year-old woman was initially referred to a community hospital for progressive fatigue and hyperbilirubinemia for 2 weeks. Six months before admission, she was started on dronedarone for atrial fibrillation. The latest liver function tests had been within normal range 9 months before admission. Her medical history included coronary artery disease and chronic obstructive pulmonary disease. She had no allergies. She did not smoke, drink alcohol, or use illicit drugs. Her current medication included aspirin, bisoprolol, dronedarone, lisinopril, hydrochlorothiazide, amlodipine, formoterol, ipratropium bromide, and simvastatin. Over the course of her hospital stay, her total bilirubin peaked at 30.3 mg/dL, she had development of coagulopathy refractory to therapy (precluding liver biopsy), and serial ultrasound Doppler …
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