title: Amiodarone-related acute respiratory distress syndrome following sudden withdrawal of steroids.
abstract: Acute lung toxicity is a rare but classical complication of amiodarone therapy. We report the case of a patient who developed an optic neuropathy after 15 years of amiodarone administration, and who was treated for 2 weeks with steroids. Following withdrawal of steroids, the patient rapidly developed an acute respiratory distress syndrome. Postmortem lung histologic examination was consistent with amiodarone-induced pneumonitis. Since this complication is thought to be of immunological origin, we speculate that the sudden withdrawal of steroids was implicated in the development of the acute lung injury.
authors.affiliation: Service de Réanimation Médicale, Dijon University Hospital, Dijon, France. pierre-emmanuel.charles@chu-dijon.fr
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Charles
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Doise
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Quenot
authors.forename: Géraldine
authors.initials: G
authors.lastname: Muller
authors.forename: Hervé
authors.initials: H
authors.lastname: Aube
authors.forename: Nicolas
authors.initials: N
authors.lastname: Baudouin
authors.forename: Françoise
authors.initials: F
authors.lastname: Piard
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Besancenot
authors.forename: Bernard
authors.initials: B
authors.lastname: Blettery
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000382:microbiology; D017809:Fatal Outcome; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D009504:Neutrophils / Q000378:metabolism; D010211:Papilledema / Q000139:chemically induced / Q000188:drug therapy*; D011014:Pneumonia / Q000139:chemically induced / Q000473:pathology; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000628:therapy; D012772:Shock, Septic / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications
chemical_list: D000305:Adrenal Cortex Hormones; D000889:Anti-Arrhythmia Agents; D000638:Amiodarone; D008775:Methylprednisolone