Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Jun 9;17(1):248.
doi: 10.1186/s13256-023-03954-6.

Amiodarone-induced blue man syndrome: a case report

Ali Hossein Samadi Takaldani  1 , Mohammad Negaresh  2 , Maryam Salimi  3 , Nima Javanshir  4
Affiliations
Case Reports

Amiodarone-induced blue man syndrome: a case report

Ali Hossein Samadi Takaldani et al. J Med Case Rep. .

Abstract

Background: Amiodarone is one of the most commonly used and effective antiarrhythmic drugs to treat ventricular and supraventricular arrhythmias. Besides its advantages, this drug has side effects like liver, digestive, pulmonary, thyroid, neural, skin, optical, hematologic, psychiatric, and cardiac complications. Blue-gray cutaneous discoloration, also known as blue man syndrome, is an undesirable and unusual side-effect of chronic amiodarone therapy in less than 3% of patients.

Case presentation: This report presents a 51-year-old Caucasian man treated for the past 3 years with amiodarone and implantable cardioverter defibrillators due to his ventricular arrhythmia and cardiomyopathy, without any follow-up visit to his doctor. He was referred to the medical center for blue-gray discoloration on his nose and cheeks, which had started to appear in the last 3 weeks.

Conclusion: Considering the findings obtained in this report and the numerous side effects of amiodarone, the blue-man syndrome is a rare yet important finding of this drug which may influence the patient's daily life. It is recommended that all patients under treatment with this drug be notified about its side effects and visit their doctors regularly. Regarding the high therapeutic value of this drug, the lack of any association between blue man syndrome and other complications, and the related aesthetic problems, the role of the caregiver becomes much more critical in the prescription of amiodarone.

Keywords: Amiodarone; Blue man syndrome; Skin toxicity.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interest to disclose.

Figures

Fig. 1
Fig. 1
Blue man syndrome. Blue-gray discoloration on cheek and nose (yellow arrow)
Fig. 2
Fig. 2
Chest imaging indicated air trapping in favor of emphysema. The red arrow shows the patient’s Implantable cardioverter defibrillators (ICD)
See this image and copyright information in PMC

References

    1. Martino E, Bartalena L, Bogazzi F, Braverman LE. The effects of amiodarone on the thyroid. Endocr Rev. 2001;22(2):240–254. - PubMed
    1. Biancatelli RMC, Congedo V, Calvosa L, Ciacciarelli M, Polidoro A, Iuliano L. Adverse reactions of amiodarone. J Geriatr Cardiol. 2019;16(7):552. - PMC - PubMed
    1. Jolly U, Klein G. Blue man syndrome. CMAJ. 2016;188(8):604. doi: 10.1503/cmaj.150393. - DOI - PMC - PubMed
    1. Jain SA, Rao MS, Mahesh AR. Blue in dermatology. 2022.
    1. Bracey NA, Zipursky JS, Juurlink DN. Argyria caused by chronic ingestion of silver. CMAJ. 2018;190(5):E139. doi: 10.1503/cmaj.171374. - DOI - PMC - PubMed

Publication types

LinkOut - more resources