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Amiodarone-induced pulmonary toxicity with an excellent response to treatment: A case report

Amiodarone is an anti-arrhythmic drug widely used, but its administration can be associated with several adverse side-effects. Among these, amiodarone-induced pulmonary toxicity (APT) occurs in 4–17% of cases and, if not early diagnosed and treated, may evolve towards pulmonary fibrosis and respirat...

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Autores principales: Terzo, Fabrizio, Ricci, Alberto, D'Ascanio, Michela, Raffa, Salvatore, Mariotta, Salvatore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911974/
https://www.ncbi.nlm.nih.gov/pubmed/31853440
http://dx.doi.org/10.1016/j.rmcr.2019.100974
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author Terzo, Fabrizio
Ricci, Alberto
D'Ascanio, Michela
Raffa, Salvatore
Mariotta, Salvatore
author_facet Terzo, Fabrizio
Ricci, Alberto
D'Ascanio, Michela
Raffa, Salvatore
Mariotta, Salvatore
author_sort Terzo, Fabrizio
collection PubMed
description Amiodarone is an anti-arrhythmic drug widely used, but its administration can be associated with several adverse side-effects. Among these, amiodarone-induced pulmonary toxicity (APT) occurs in 4–17% of cases and, if not early diagnosed and treated, may evolve towards pulmonary fibrosis and respiratory failure. A 76 years-old-man went to the hospital for accidental trauma. The patient did not report respiratory symptoms but was suffering from atrial fibrillation treated with amiodarone 200 mg/day from three years (cumulative dose >150 gr). HRCT showed ground-glass opacities and nodules in both lungs. The patient underwent fibreoptic bronchoscopy with BAL. Cytologic examination of BALF sediment put in evidence foamy macrophages. The electronic microscopy revealed into the alveolar macrophages “… the presence of multilamellar intracytoplasmic bodies and lysosomes, loads of lipid material”. LFTs showed a restrictive syndrome and an impairment of DLCO. Amiodarone discontinuation and steroid administration led to the regression of radiological lesions and the recovery of lung function. Patients taking amiodarone can experience APT. They should perform a basal chest x-ray with LFTs before starting therapy. Monitoring could reveal early the pulmonary toxicity, and patients can respond favourably to the treatment.
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spelling pubmed-69119742019-12-18 Amiodarone-induced pulmonary toxicity with an excellent response to treatment: A case report Terzo, Fabrizio Ricci, Alberto D'Ascanio, Michela Raffa, Salvatore Mariotta, Salvatore Respir Med Case Rep Case Report Amiodarone is an anti-arrhythmic drug widely used, but its administration can be associated with several adverse side-effects. Among these, amiodarone-induced pulmonary toxicity (APT) occurs in 4–17% of cases and, if not early diagnosed and treated, may evolve towards pulmonary fibrosis and respiratory failure. A 76 years-old-man went to the hospital for accidental trauma. The patient did not report respiratory symptoms but was suffering from atrial fibrillation treated with amiodarone 200 mg/day from three years (cumulative dose >150 gr). HRCT showed ground-glass opacities and nodules in both lungs. The patient underwent fibreoptic bronchoscopy with BAL. Cytologic examination of BALF sediment put in evidence foamy macrophages. The electronic microscopy revealed into the alveolar macrophages “… the presence of multilamellar intracytoplasmic bodies and lysosomes, loads of lipid material”. LFTs showed a restrictive syndrome and an impairment of DLCO. Amiodarone discontinuation and steroid administration led to the regression of radiological lesions and the recovery of lung function. Patients taking amiodarone can experience APT. They should perform a basal chest x-ray with LFTs before starting therapy. Monitoring could reveal early the pulmonary toxicity, and patients can respond favourably to the treatment. Elsevier 2019-11-29 /pmc/articles/PMC6911974/ /pubmed/31853440 http://dx.doi.org/10.1016/j.rmcr.2019.100974 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Terzo, Fabrizio
Ricci, Alberto
D'Ascanio, Michela
Raffa, Salvatore
Mariotta, Salvatore
Amiodarone-induced pulmonary toxicity with an excellent response to treatment: A case report
title Amiodarone-induced pulmonary toxicity with an excellent response to treatment: A case report
title_full Amiodarone-induced pulmonary toxicity with an excellent response to treatment: A case report
title_fullStr Amiodarone-induced pulmonary toxicity with an excellent response to treatment: A case report
title_full_unstemmed Amiodarone-induced pulmonary toxicity with an excellent response to treatment: A case report
title_short Amiodarone-induced pulmonary toxicity with an excellent response to treatment: A case report
title_sort amiodarone-induced pulmonary toxicity with an excellent response to treatment: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911974/
https://www.ncbi.nlm.nih.gov/pubmed/31853440
http://dx.doi.org/10.1016/j.rmcr.2019.100974
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