[Amiodarone-induced pneumonitis. Lethal complication in a patient after thoracic surgery].
The case of a 69-year-old patient is reported with non-small cell lung cancer who underwent lobectomy with sleeve resection and postoperatively developed intermittent atrial tachyarrhythmia. The patient was treated with a beta-blocker and the class III antiarrhythmic drug amiodarone, which resulted in normal frequency sinus rhythm. After pharmacological saturation with amiodarone, fibrosis of the lungs developed with subsequent respiratory insufficiency. Despite maximum intensive care therapy the patient died 9 weeks after surgery of hypoxemia-related multiple organ dysfunction syndrome. Based on this case amiodarone-related pneumonitis will be discussed, which due to a lack of pathognomonic symptoms is often difficult to diagnose and for which there are few treatment options available. The differential diagnoses of pneumonitis will also be discussed.
Ghezel-Ahmadi
V
V
Klinik für Anästhesiologie und Intensivmedizin, Dr. Horst Schmidt Klinik, Ludwig-Erhard-Str. 100, 65199 Wiesbaden, Deutschland.
Kürschner
V C
VC
Fisseler-Eckhoff
A
A
Schirren
J
J
Schmitz
J E
JE
Obenhaus
T
T
D000368:Aged; D000638:Amiodarone / Q000009:adverse effects* / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005355:Fibrosis / Q000139:chemically induced / Q000473:pathology; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis; D013610:Tachycardia / Q000150:complications / Q000188:drug therapy; D019616:Thoracic Surgical Procedures
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone