Amiodarone-induced Alveolar Haemorrhage: A Rare Complication of a Common Medication

Tanawuttiwat, Tanyanan; Harindhanavudhi, Tasma; Hanif, Sara; Sahloul, M. Z.

doi:10.1016/j.hlc.2010.01.008

Cited by 27 publications

(12 citation statements)

References 15 publications

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“…Review of the literature revealed a total of 15 prior reported cases of DAH secondary to amiodarone (table 1). 8 12–23 The mean age of the patients was 65.4 years, ranging from 37 to 70 years of age. This complication appears to be more common in men, and 14 of the reported cases were in men, while only one was reported in women.…”

Section: Discussionmentioning

confidence: 99%

“…Prussian blue stain demonstrating hemosiderin-laden macrophages are present, and are typically in larger numbers than in cardiogenic pulmonary oedema. Another microscopic finding that may be present is the presence of foamy macrophages due to accumulation of amiodarone-linked phospholipids, and these can be found in patients taking amiodarone who do not suffer from any pulmonary toxicity 8. The treatment of DAH usually entails discontinuation of amiodarone and high-dose steroids, though other benefits and dosing of steroid therapy for this complication are uncertain.…”

Section: Introductionmentioning

confidence: 99%

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Republished: Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication

Saeed

Waqas

Khan

et al. 2020

DTB

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Republished: Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication

Saeed

Waqas

Khan

et al. 2020

DTB

View full text Add to dashboard Cite

“…Review of the literature revealed a total of 15 prior reported cases of DAH secondary to amiodarone (table 1). 8 12–23 The mean age of the patient was 65.4 years, ranging from 37 to 70 years of age. This complication appears to be more common in men, and n=14 of the prior reported cases were in men, while only n=1 was reported in women.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication

et al. 2019

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Amiodarone is an antiarrhythmic agent that is used commonly in clinical practice. It is associated with many side effects, the most common being pulmonary manifestations. Interstitial pneumonitis is one of the most common complications, however rarely amiodarone can cause diffuse alveolar haemorrhage (DAH) too. We describe the case of a 73-year-old woman who presented with shortness of breath and haemoptysis 4 days after starting amiodarone. She was diagnosed with amiodarone-induced DAH based on imaging and bronchoalveolar lavage. She was treated with intravenous and then oral steroids, and amiodarone was discontinued. The patient made a significant clinical and radiological recovery. She was discharged 10 days after her presentation. This case highlights a rare but potentially life-threatening complication of a commonly used medication.

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“…There are two major hypotheses regarding APT: immune-mediated hypersensitivity and the direct cytotoxicity of drug-induced phospholipidosis [6,13]. Moreover, amiodarone has several pharmacological properties that contribute to its toxicities [2,14], including the presence of two iodine atoms that result in the release of 7 mg iodine per 200 mg amiodarone (normal iodine intake, 150 to 200 µg/day), its lipophilic nature and high affinity for tissue accumulation, long half-life, and a large distribution volume.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic utility of chest computed tomography scoring for the assessment of amiodarone-induced pulmonary toxicity

Kang

Kim

et al. 2014

Korean J Intern Med

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Background/AimsAmiodarone is one of the most widely used antiarrhythmic agents; however, amiodarone-induced pulmonary toxicity (APT) can be irreversible and sometimes fatal. The aim of this study was to evaluate the feasibility of chest computed tomography (CT) as a diagnostic tool for APT and to assess the utility of the CT APT score as an index for predicting the severity of APT.MethodsPatients underwent amiodarone treatment for various reasons, most often atrial fibrillation, for more than 2 years, and those that received a cumulative dose > 100 g were enrolled. A total of 34 patients who underwent chest CT between December 2011 and June 2012 were enrolled, whether or not they had clinical symptoms. The APT CT score was defined as the number of involved regions in the lung, which was divided into 18 regions (right and left, upper, middle, and lower, and central, middle, and peripheral). The CT findings were evaluated according to the total dose and duration of amiodarone treatment and the results of a pulmonary function test. Clinical symptoms and outcomes were also evaluated according to APT CT scores.ResultsSeven patients had positive APT CT scores (interstitial fibrosis in five, organizing pneumonia in one, and mixed interstitial fibrosis and organizing pneumonia in one), and these patients exhibited significantly lower diffusion capacity for carbon monoxide in the lungs compared with patients without an increased APT CT score (70.2% ± 6.9% vs. 89.7% ± 19.4%; p = 0.011). Three of the seven patients experienced overt APT that required hospital admission.ConclusionsChest CT is a useful diagnostic tool for APT, and the APT CT score might be a useful index for assessing the severity of APT.

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Amiodarone-induced Alveolar Haemorrhage: A Rare Complication of a Common Medication

Cited by 27 publications

References 15 publications

Republished: Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication

Republished: Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication

Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication

The diagnostic utility of chest computed tomography scoring for the assessment of amiodarone-induced pulmonary toxicity

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