Introduction: Ciclosporin A is an immunosuppressive molecule widely used in Behçet's disease (BD), especially for severe ocular and/or neurological disorders. Its particular toxicity in this field has, however, largely limited its use during this vasculitis. We report an aspect.Case report: 26-year-old patient followed since the age of 20 for BD with severe ocular involvement (bilateral posterior steroid-resistant uveitis with a significant decrease in visual acuity) requiring treatment with Ciclosporin A at a dose of 5mg/kg/twice daily during the first month and then 5mg/kg/day as a maintenance dose to control uveitis. The one-year control report noted a creatinine at 147μmol/l with aseptic leucocyturia at 400 elements/l. blood pressure was normal and there was no associated hematuria or proteinuria. The infectious and toxic investigation was normal. The ultrasound showed two kidneys of normal size and echo-structure. Renal biopsy revealed acute interstitial nephritis with images of toxic tubular necrosis. Cyclosporine was discontinued and replaced with azathioprine. Renal function normalized three weeks after stopping the molecule. Conclusion:periodic and regular monitoring of renal function (blood and urine tests) is strongly recommended in order to detect renal damage early in the BD; especially if Ciclosporin A treatment.

IntroductionAmiodarone is a class III antiarrhythmic agent widely used for the treatment of ventricular and supraventricular rhythm disorders [1,2]; its spectrum of toxicity is wide: thyroid, heart, lung, eye, skin, liver, gastrointestinal tract, and central nervous system [3]. All these effects are mediated by the mitochondrial toxicity of the drug and its lipophilicity. This toxicity is not dose-dependent, can occur even very early, and men seems to be more exposed than women [4]. The current incidence of amiodarone pneumonia is estimated at 1.6-2% [5,6]. His most classic presentation is acute or subacute pneumonia, while pleural involvement is exceptional [3,7] and often described as an unusual manifestation of amiodarone-induced pneumopathy [7,8]; similarly, acute hepatitis under amiodarone is very rare (<3%) [6]. We are reporting an original observation of triple toxicity to amiodarone with concomitant bilateral pleural, pulmonary parenchymal and hepatic involvement.