title: [Amiodarone pulmonary toxicity: case report].
abstract: BACKGROUND
  Amiodarone, an antiarrhythmic drug, which contains iodine compound, has a tendency to accumulate in some organs including the lungs.This is age, drug dosage and therapy duration dependent.
  
  
  METHODS
  We present a case of a 73-year-old man, a smoker, who was admitted as emergency case due to severe dyspnea, tachypnea with signs of cyanosis and respiratory insufficiency. Chest x-ray revealed bilateral diffuse pulmonary shadows in the middle and upper parts of the lungs, similar to those in tuberculosis. His illness history showed chronic obstructive pulmonary disease, arterial hypertension, and atrial fibrillation which has been treated with amiodarone for six years. Sputum smears were negative for mycobacteria, and by the diagnostic elimination method for specific, non-specific and malignant disease the diagnosis of amiodarone pulmonary toxicity was made. Fiberoptic bronchoscopy and pathohistological findings of bronchiolitis obliterans organizing pneumonia confirmed the diagnosis. As the first therapeutic approach, amiodarone therapy was stopped.Then, systemic therapy with methylprednisolone 21 (sodium succinate) 40 mg i.v. daily during the first two weeks was initiated and continued with daily dose of methylprednisolone 30 mg orally during the next three months. The patient showed a marked subjective improvement during the first week, which was followed by the improvement of respiratory function and withdrawal of pulmonary changes with complete radiographic and CT resolution after eight months.
  
  
  CONCLUSIONS
  Amiodarone pulmonary toxicity should be taken into consideration, especially in elderly patients with respiratory symptoms and pulmonary changes, even if only a low dose of amiodarone is administred over a longer time period.
authors.forename: Nada
authors.initials: N
authors.lastname: Vasić
authors.forename: Dragica
authors.initials: D
authors.lastname: Pesut
authors.forename: Ruza
authors.initials: R
authors.lastname: Stević
authors.forename: Dragana
authors.initials: D
authors.lastname: Jovanović
authors.forename: Slavisa
authors.initials: S
authors.lastname: Radivojević
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000633:toxicity*; D000889:Anti-Arrhythmia Agents / Q000633:toxicity*; D018549:Cryptogenic Organizing Pneumonia / Q000139:chemically induced*; D006801:Humans; D008297:Male
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone