Initial characteristics and outcome of hospitalized patients with amiodarone pulmonary toxicity

Mankikian, Julie; Favelle, O.; Guillon, Antoine; Guilleminault, L.; Cormier, B.; Jonville‐Béra, Annie‐Pierre; Perrotin, D.; Diot, Patrice; Marchand-Adam, S.

doi:10.1016/j.rmed.2014.01.014

Cited by 31 publications

(30 citation statements)

References 38 publications

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“…A resolution of findings can occur over two to eight weeks. High-resolution CT can reveal diffuse bilateral ground-glass opacification, alveolar consolidation, intra-alveolar reticulations, and pleural effusions [11]. In this case, patient history, exam, and workup, including ECG, troponin, and echocardiogram, make cardiac pathology less likely.…”

Section: Discussionmentioning

confidence: 95%

“…Treatment with systemic corticosteroids was found in one study to induce relapse when treatment lasted for less than three months but not longer than six months, probably attributable to the 40-70 day half-life elimination of amiodarone and storage in the lung parenchyma. Positive effects were noted on alveolar opacifications [11]. An initial dose of 0.75-1 mg/kg of prednisolone should be maintained until there is a definite clinical and radiographic response, as recurrence can be more severe than the initial episode.…”

Section: Discussionmentioning

confidence: 98%

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A Case of Amiodarone Pulmonary Toxicity with Short-term Amiodarone Use

McDonald

2020

Cureus

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This is the case of a 92-year-old female who was hospitalized one month prior to admission for symptomatic paroxysmal atrial fibrillation, requiring intravenous amiodarone. Following her previous admission, she was placed on one month of amiodarone 200 mg twice daily, with a one week transition to 200 mg daily. The patient subsequently developed progressive shortness of breath and dry cough over a period of several weeks. Initial imaging showed diffuse bilateral coarse patchy interstitial infiltration on chest X-ray and bibasilar pleural effusions and scattered bilateral opacities on CTA chest. In an elderly patient presenting with dyspnea and dry cough, as well as interstitial opacities on imaging, amiodarone pulmonary toxicity should be considered despite short-term low-dose use.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 98%

A Case of Amiodarone Pulmonary Toxicity with Short-term Amiodarone Use

McDonald

2020

Cureus

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“…. Outros fatores de risco incluem gênero masculino, doença pulmonar préexistente, idade avançada, exposição a altas concentrações de oxigênio 1,2,5,6,8 . Pneumonite aguda associada ao uso de amiodarona por curto período de tempo é muito mais rara.…”

Section: Discussionunclassified

Bronquiolite Obliterante E Pneumonia Em Organização Secundária Ao Uso De Amiodarona

Cunha¹,

Frandoloso

Lagana

et al. 2015

Rev. Med. UFPR

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A amiodarona é um antiarrítmico comumente utilizado na prática clínica e pode estar associado a diversos efeitos adversos, muitos deles com significativa morbimortalidade, como o acometimento pulmonar. O presente caso descreve uma mulher de 63 anos com toxicidade pulmonar aguda pela amiodarona, utilizada em curto período de tempo. A realização de biópsia pulmonar demonstrou bronquiolite obliterante e pneumonia em organização (BOOP). Após interrupção do uso do antiarrítmico e o início da corticoterapia, a paciente obteve expressiva melhora clínica e radiológica.

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“…3,4 Incidence/Risk Factor APT is a serious adverse event that occurs in approximately 2 to 5% of treated patients 5 and mortality at day 90 was reported to be 37%. 6 APT can develop as early as from the first few days of treatment to several years later and even after discontinuation of the therapy. 7 Viswam et al reported an incidence of APT on a 58-year-old male patient postcoronary artery bypass grafting after a day's loading dose of amiodarone.…”

Section: Discussionmentioning

confidence: 99%

Early Amiodarone-Induced Pulmonary Toxicity after Endovascular Aneurysm Repair: A Case Report

et al. 2014

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Amiodarone is an antiarrhythmic drug that has been commonly used to treat supraventricular and ventricular arrhythmias. This drug is an iodine-containing compound that tends to accumulate in several organs, including the lungs. Especially, its main metabolically active metabolite desethylamiodarone can adversely affect many organs. A very well-known severe complication of amiodarone therapy is the amiodarone-induced pulmonary toxicity. This article presents the case study of an 82-year-old male patient with acute amiodarone-induced pulmonary toxicity. The patient underwent endovascular aneurysm repair for rapidly increasing abdominal aortic aneurysm. During the postoperative period the patient developed rapid atrial fibrillation and amiodarone therapy was initiated. Subsequently, the patient went into acute respiratory failure and was requiring high supplemental oxygen support and a chest X-ray revealed bilateral pulmonary infiltrates. During the hospital course the patient required mechanical ventilator support. With discontinuation of amiodarone, supportive therapy and steroid treatment patient symptoms significantly improved. Amiodarone-induced pulmonary toxicity must be considered in the differential diagnosis of all patients on the medication with progressive or acute respiratory symptoms. Early discontinuation of amiodarone and aggressive corticosteroid therapy should be considered as a viable treatment strategy.

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Initial characteristics and outcome of hospitalized patients with amiodarone pulmonary toxicity

Abstract: Severity of APT is linked to the extent and speed of onset of pulmonary damage. After the initial episode, the patients who survived improved slowly but with persistent sequelae.

Cited by 31 publications

References 38 publications

A Case of Amiodarone Pulmonary Toxicity with Short-term Amiodarone Use

A Case of Amiodarone Pulmonary Toxicity with Short-term Amiodarone Use

Bronquiolite Obliterante E Pneumonia Em Organização Secundária Ao Uso De Amiodarona

Early Amiodarone-Induced Pulmonary Toxicity after Endovascular Aneurysm Repair: A Case Report

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