Amiodarone-related acute respiratory distress syndrome following sudden withdrawal of steroids.
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.
Charles
Pierre-Emmanuel
PE
Service de Réanimation Médicale, Dijon University Hospital, Dijon, France. pierre-emmanuel.charles@chu-dijon.fr
Doise
Jean-Marc
JM
Quenot
Jean-Pierre
JP
Muller
Géraldine
G
Aube
Hervé
H
Baudouin
Nicolas
N
Piard
Françoise
F
Besancenot
Jean-François
JF
Blettery
Bernard
B
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
D000305:Adrenal Cortex Hormones; D000889:Anti-Arrhythmia Agents; D000638:Amiodarone; D008775:Methylprednisolone