Amiodarone lung toxicity

Amiodarone, an antiarrhythmic agent, is known to induce pulmonary toxicity in some patients. Previously described radiographic findings include alveolar and interstitial infiltrates. We report a patient who developed biapical infiltrates on chest X-ray film and demonstrated an unusual, symmetric appearance on CT. Correlative postmortem histologic findings are presented. Amiodarone-induced pulmonary toxicity should be considered in the differential diagnosis of pulmonary parenchymal infiltrates seen on CT of patients receiving this medication...

The new anti-arrhythmic agent, amiodarone, is increasingly recognized as a cause of pulmonary toxicity (APT). In the present series, 11 of 171 patients (6.4%) receiving the drug had APT develop. Clinical symptoms varied from mild cough and dyspnea to acute respiratory failure. Chest x-rays demonstrated alveolar and/or interstitial opacities in all 11 patients. The microscopic appearance of APT resembled that seen in lung injury from other drugs. The features were those of diffuse alveolar damage, ranging from the early acute to the organizing phase...

Of the side effects that complicate amiodarone therapy, pulmonary fibrosis is potentially the most serious. Therefore, the development of techniques to predict the onset of this troublesome reaction would be of great practical value. Reports of 39 patients who developed pulmonary toxicity with amiodarone were evaluated for clues to precipitating factors and information on the response to corticosteroid treatment. The majority of patients were being given maintenance doses greater than 400 mg/day. Patients appeared to improve after withdrawal of amiodarone, both with and without corticosteroid treatment...

Implantable cardioverter defibrillator (ICD) implantation is rapidly becoming accepted as primary therapy for malignant ventricular arrhythmias. Many patients undergoing ICD implantation are on concomitant antiarrhythmic drugs to decrease shock frequency, slow tachycardia rate, and suppress supraventricular arrhythmias. Amiodarone is a potent antiarrhythmic agent that is also frequently used in the treatment of patients with refractory ventricular arrhythmias. Ten to forty percent of patients undergoing ICD implantation will also be taking amiodarone...

Amiodarone causes accumulation of phospholipids in lung alveolar cells, and this phospholipidosis invariably is present when amiodarone pulmonary toxicity is recognized. This effect has usually been demonstrated in patients following several months of therapy. The authors report the occurrence of pulmonary phospholipidosis, diagnosed by bronchoalveolar lavage, six days after commencing intravenous amiodarone therapy.

A 74-year-old woman presented with a one-week history of persistent cough. A chest x-ray and computed tomography images revealed features mimicking lung cancer, which included a large solitary consolidation and hilar lymphadenopathy. She had received low-dose amiodarone (200 mg/day) for treatment of atrial fibrillation for more than 2.5 years. The tumour-like abnormalities did not disappear until the discontinuation of amiodarone therapy. The finding of low-dose amiodarone causing tumour-like abnormalities on a chest x-ray is unique...

BACKGROUND: Amiodarone, class III anti-arrhythmic was originally introduced to treat angina pectoris, was later approved by FDA in 1985 for the treatment of ventricular arrhythmias. Despite its anti-arrhythmic properties, amiodarone is associated with side effects such as thyroid dysfunction, corneal deposits, bluish skin discoloration, neuropathy and pulmonary toxicity. Amiodarone induced pulmonary toxicity (AIPT) is one of the most serious side effect thus limiting its use. CASE REPORT: We encountered a 66 year old male with early onset AIPT who presented with dyspnea and chest imaging revealed extensive ground-glass opacities throughout lung parenchyma with rapid resolution of these opacities in a week following treatment with corticosteroids...

Amiodarone is an effective anti-arrhythmic agent. However, during long-term therapy, patients can develop severe adverse pulmonary reactions that are potentially life-threatening. A case of amiodarone-induced pulmonary toxicity is presented in a 78-year-old woman. She developed dyspnea and a pulmonary mass with associated multiple lung nodules mimicking a lung cancer following 5 years of treatment with amiodarone for atrial fibrillation. After drug withdrawal, and without any additional treatment, clinical and radiological improvement was observed, and radiological findings resolved completely within 6 months...

CONTEXT: The histologic patterns of diffuse alveolar damage (DAD), bronchiolitis obliterans with organizing pneumonia (BOOP), and eosinophilic pneumonia (EP) are well-recognized histologic patterns of lung injury associated with an acute or subacute clinical presentation. We have recognized acute fibrinous and organizing pneumonia (AFOP) as a histologic pattern, which also occurs in this clinical setting but does not meet the classic histologic criteria for DAD, BOOP, or EP and may represent an underreported variant...

Our study showed a statistically significant incidence of pulmonary edema in mice receiving amiodarone and 100% oxygen. This finding, together with a variety of clinical reports, indicates that in patients receiving amiodarone therapy, FiO2 should be maintained at the lowest possible level, consistent with adequate oxygenation.

Bronchiolitis obliterans organizing pneumonia (BOOP) is a clinicopathological entity with well-defined diagnostic criteria, the aetiology of which is generally unknown. Among the adverse pulmonary effects of the drug amiodarone, BOOP is the least commonly reported in the literature. In this article we describe a case of amiodarone-induced BOOP.

A patient with types A and B of Wolff-Parkinson-White syndrome developed subacute pneumonitis during long-term treatment with amiodarone. The pneumopathy occurred only when the maintenance dose was increased to 800 mg/day. Lung specimens obtained by transbronchial biopsy showed chronic pneumonitis with C3 deposition by immunofluorescence. Pulmonary signs spontaneously disappeared two months after the drug was discontinued.

Cryptogenic organizing pneumonia (formerly known as bronchiolitis obliterans organizing pneumonia) is a clinicopathological entity with characteristical radiographic findings such as bilateral, asymmetrical, sometimes migrating, patchy infiltrates in chest radiograph and ground-glass opacities in computed tomography. The disease has been observed in the context of gastrointestinal disorders, certain lung infections, autoimmune-mediated diseases (such as Wegener granulomatosis), inhalation of toxic fumes, bone marrow transplantation and administration of drugs...

Amiodarone is an antiarrhythmic benzoflurane drug with an imposing adverse effect profile. Amiodarone pulmonary toxicity is the major complication. It is well described in adults, whereas it is extremely rare in pediatric patients. This is a case of a child with supraventricular tachycardia post repair of transposition of the great vessels who developed amiodarone toxicity.

OBJECTIVE: To investigate any relationship between the pathological features of amiodarone-induced pulmonary toxicity (APT) and clinical use of amiodarone in patients dying from acute respiratory distress syndrome (ARDS). DESIGN: Retrospective study. Review of clinical and pathological findings of patients dying from ARDS. SETTING: Intensive Care Unit (ICU) and Pathology Department of University hospital. SUBJECTS: Ten patients with clinical diagnosis of ARDS, who died in ICU and underwent post mortem examination...

Problems with pulmonary toxicity have emerged as a potentially limiting factor for amiodarone use. We studied 24 consecutive patients receiving low-dose (i.e., less than or equal to 400 mg/day) amiodarone for refractory tachyarrhythmias. Serial pulmonary function test results were correlated with daily dose, serum concentration, cumulated dose, and duration of amiodarone treatment to determine the effect of the drug on pulmonary function. The mean follow-up period for the 24 patients, who completed baseline and follow-up evaluations, was 47 months (range 31 to 75 months)...

Amiodarone is an effective agent in the treatment of life-threatening ventricular arrhythmias. However, there are numerous side effects associated with this drug, including pulmonary toxicity. This report describes a pulmonary mass that developed in a patient receiving amiodarone and was initially thought to be a lung cancer. Complete resolution occurred after cessation of the drug.

BACKGROUND: Amiodarone (AM) is a widely used anti-arrhythmic medication. Its utility is, however, limited by adverse side effects. The mechanism of amiodarone-induced toxicity (APT) in the lungs is attributed primarily to stimulation of the angiotensin enzyme system leading to lung cell apoptosis and cell death. This mechanism has been demonstrated by in vitro and in vivo experimental animal studies. To date, however, no in vivo human studies have confirmed this mechanism for APT. PURPOSE: This study was undertaken to determine whether angiotensin converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB) offer a protective effect against APT in humans...

Amiodarone-induced pulmonary toxicity has been described mostly in patients receiving large doses of the drug over prolonged periods. In this report, we describe the early onset of acute pulmonary toxicity leading to acute respiratory distress syndrome after a short course of amiodarone treatment following middle-lobe non-small-cell lung cancer resection.

A prospective study was conducted of 189 patients treated with amiodarone, maintained at doses of 400 to 800 mg/day and followed for up to 6 years. Only patients who had life-threatening ventricular arrhythmias unresponsive to conventional therapy were enrolled, and they underwent baseline pretreatment pulmonary function tests, with follow-up testing every 6 months. Morbidity and mortality statistics were confirmed by chart review and patient telephone interview. Of the 189 enrolled patients, 101 are alive, 84 are dead and 4 are lost to follow-up...