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Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis

Patient: Male, 73-year-old Final Diagnosis: Amiodarone induced SIRS response and organizing pneumonia Symptoms: Abdominal pain • fever • nausea • vomiting Medication: — Clinical Procedure: Bronchoalveolar lavage • bronchoscopy • trans-bronchial biopsy Specialty: Critical Care Medicine OBJECTIVE: Unu...

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Autores principales: Kugasia, Irfanali R., Ijaz, Mohsin, Khan, Ahsan, Jasti, Yashwanth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592337/
https://www.ncbi.nlm.nih.gov/pubmed/33095757
http://dx.doi.org/10.12659/AJCR.926929
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author Kugasia, Irfanali R.
Ijaz, Mohsin
Khan, Ahsan
Jasti, Yashwanth
author_facet Kugasia, Irfanali R.
Ijaz, Mohsin
Khan, Ahsan
Jasti, Yashwanth
author_sort Kugasia, Irfanali R.
collection PubMed
description Patient: Male, 73-year-old Final Diagnosis: Amiodarone induced SIRS response and organizing pneumonia Symptoms: Abdominal pain • fever • nausea • vomiting Medication: — Clinical Procedure: Bronchoalveolar lavage • bronchoscopy • trans-bronchial biopsy Specialty: Critical Care Medicine OBJECTIVE: Unusual clinical course BACKGROUND: Amiodarone, an anti-arrhythmic medication, has been associated with the development of multiple organ toxicities. Most of these toxicities develop insidiously. However, in rare cases, these toxicities manifest with more acute symptoms. We present an unusual case of amiodarone toxicity which manifested with multiorgan failure and systemic inflammatory response syndrome that mimicked sepsis. CASE REPORT: A 73-year-old man who was being treated with chronic oral amiodarone for atrial fibrillation presented with flu-like symptoms and fever, pulmonary infiltrate, acute kidney injury, and thrombocytopenia. The patient did not improve with antibiotics and fluid resuscitation. The results of an extensive infectious and non-infectious workup were negative. His symptoms worsened during hospitalization, which correlated with the loading of intravenous amiodarone given for his acute worsening of atrial fibrillation. Amiodarone-induced drug toxicity was contemplated by the treating medical team. Amiodarone was stopped, and the patient was treated with steroids, which improved his symptoms and organ dysfunctions. Subsequent bronchoscopy with lung biopsy showed foamy macrophages with organizing pneumonia and fibrinoid changes. CONCLUSIONS: This case highlights an atypical and rare presentation of a complication of chronic amiodarone use that presented with acute onset of fever, systemic inflammatory response syndrome, and multiorgan failure masquerading as sepsis. The patient’s symptoms and organ dysfunctions improved with the discontinuation of amiodarone and institution of steroids.
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spelling pubmed-75923372020-10-28 Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis Kugasia, Irfanali R. Ijaz, Mohsin Khan, Ahsan Jasti, Yashwanth Am J Case Rep Articles Patient: Male, 73-year-old Final Diagnosis: Amiodarone induced SIRS response and organizing pneumonia Symptoms: Abdominal pain • fever • nausea • vomiting Medication: — Clinical Procedure: Bronchoalveolar lavage • bronchoscopy • trans-bronchial biopsy Specialty: Critical Care Medicine OBJECTIVE: Unusual clinical course BACKGROUND: Amiodarone, an anti-arrhythmic medication, has been associated with the development of multiple organ toxicities. Most of these toxicities develop insidiously. However, in rare cases, these toxicities manifest with more acute symptoms. We present an unusual case of amiodarone toxicity which manifested with multiorgan failure and systemic inflammatory response syndrome that mimicked sepsis. CASE REPORT: A 73-year-old man who was being treated with chronic oral amiodarone for atrial fibrillation presented with flu-like symptoms and fever, pulmonary infiltrate, acute kidney injury, and thrombocytopenia. The patient did not improve with antibiotics and fluid resuscitation. The results of an extensive infectious and non-infectious workup were negative. His symptoms worsened during hospitalization, which correlated with the loading of intravenous amiodarone given for his acute worsening of atrial fibrillation. Amiodarone-induced drug toxicity was contemplated by the treating medical team. Amiodarone was stopped, and the patient was treated with steroids, which improved his symptoms and organ dysfunctions. Subsequent bronchoscopy with lung biopsy showed foamy macrophages with organizing pneumonia and fibrinoid changes. CONCLUSIONS: This case highlights an atypical and rare presentation of a complication of chronic amiodarone use that presented with acute onset of fever, systemic inflammatory response syndrome, and multiorgan failure masquerading as sepsis. The patient’s symptoms and organ dysfunctions improved with the discontinuation of amiodarone and institution of steroids. International Scientific Literature, Inc. 2020-10-23 /pmc/articles/PMC7592337/ /pubmed/33095757 http://dx.doi.org/10.12659/AJCR.926929 Text en © Am J Case Rep, 2020 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Kugasia, Irfanali R.
Ijaz, Mohsin
Khan, Ahsan
Jasti, Yashwanth
Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis
title Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis
title_full Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis
title_fullStr Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis
title_full_unstemmed Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis
title_short Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis
title_sort amiodarone toxicity presenting with acute onset of systemic inflammatory response syndrome and multiorgan failure mimicking sepsis
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592337/
https://www.ncbi.nlm.nih.gov/pubmed/33095757
http://dx.doi.org/10.12659/AJCR.926929
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