title: Amiodarone-related pneumonitis.
abstract: 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.
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Chang
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Kuan-Lih
authors.initials: KL
authors.lastname: Hsu
authors.forename: Chia-Ti
authors.initials: CT
authors.lastname: Tsai
authors.forename: Ling-Ping
authors.initials: LP
authors.lastname: Lai
authors.forename: Jiunn-Lee
authors.initials: JL
authors.lastname: Lin
authors.forename: Chuen-Den
authors.initials: CD
authors.lastname: Tseng
authors.forename: Fu-Tien
authors.initials: FT
authors.lastname: Chiang
mesh_terms: 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
chemical_list: D000889:Anti-Arrhythmia Agents; D005938:Glucocorticoids; D011239:Prednisolone; D000638:Amiodarone