Amiodarone-related pneumonitis.
Amiodarone-related pneumonitis is a potentially limiting factor for amiodarone usage. However, it is believed that amiodarone-related pneumonitis is unlikely to occur during low-dose and short courses of therapy. We report three patients who received low-dose amiodarone, 200 mg/day, for an average of 6.6 months and who developed amiodarone-related pneumonitis. All patients were male with age of 75, 93 and 85, respectively, and had the habit of cigarette smoking. The initial presentation was dyspnea without symptoms and signs of heart failure. Their chest radiographs showed diffuse interstitial pneumonitis pattern and chest computed tomography scan also confirmed interstitial pneumonitis. Treatment included cessation of amiodarone and corticosteroid usage. All patients improved symptomatically by early detection and early treatment. This case report implies that old age and possible pre-existing pulmonary abnormalities caused by smoking could be associated with amiodarone-related pulmonary toxicity. Clinicians must remain alert to detect amiodarone-related pneumonitis even under low dosage and short duration of amiodarone usage. Immediate withdrawal of amiodarone and prompt steroid therapy will ensure full recovery.
Chang
Sheng-Nan
SN
Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Hwang
Juey-Jen
JJ
Hsu
Kuan-Lih
KL
Tsai
Chia-Ti
CT
Lai
Ling-Ping
LP
Lin
Jiunn-Lee
JL
Tseng
Chuen-Den
CD
Chiang
Fu-Tien
FT
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D012907:Smoking / Q000009:adverse effects
D000889:Anti-Arrhythmia Agents; D005938:Glucocorticoids; D011239:Prednisolone; D000638:Amiodarone