Amiodarone-related acute respiratory distress syndrome following sudden withdrawal of steroids

Respiration. 2006;73(2):248-9. doi: 10.1159/000088010. Epub 2005 Aug 30.

Abstract

Acute lung toxicity is a rare but classical complication of amiodarone therapy. We report the case of a patient who developed an optic neuropathy after 15 years of amiodarone administration, and who was treated for 2 weeks with steroids. Following withdrawal of steroids, the patient rapidly developed an acute respiratory distress syndrome. Postmortem lung histologic examination was consistent with amiodarone-induced pneumonitis. Since this complication is thought to be of immunological origin, we speculate that the sudden withdrawal of steroids was implicated in the development of the acute lung injury.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Aged
  • Amiodarone / administration & dosage
  • Amiodarone / adverse effects*
  • Anti-Arrhythmia Agents / administration & dosage
  • Anti-Arrhythmia Agents / adverse effects*
  • Bronchoalveolar Lavage Fluid / cytology
  • Bronchoalveolar Lavage Fluid / microbiology
  • Fatal Outcome
  • Humans
  • Lung / pathology
  • Male
  • Methylprednisolone / therapeutic use*
  • Neutrophils / metabolism
  • Papilledema / chemically induced
  • Papilledema / drug therapy*
  • Pneumonia / chemically induced
  • Pneumonia / pathology
  • Respiration, Artificial
  • Respiratory Distress Syndrome / chemically induced*
  • Respiratory Distress Syndrome / therapy
  • Shock, Septic / microbiology
  • Staphylococcal Infections / complications

Substances

  • Adrenal Cortex Hormones
  • Anti-Arrhythmia Agents
  • Amiodarone
  • Methylprednisolone