Key Words: amiodarone, pulmonary fibrosis, acute pulmonary toxicity
Abstract
Amiodarone, considered a potent antiarrhythmic, is known to cause pulmonary toxicity. Chronic interstitial pneumonitis is the most common presentation. However, acute pulmonary toxicity is rare and has a higher case fatality rate. We present a 61-year-old patient with persistent atrial fibrillation who, after a one-month treatment with oral amiodarone at a low dose impregnation of 400 mg/day, develops acute pulmonary toxicity, with radiographic and tomographic resolution after antiarrhythmic suspension and steroid treatment.
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Se sabe que la amiodarona, un potente antiarrítmico, causa toxicidad pulmonar. La neumonitis intersticial crónica es la presentación más común. Sin embargo, la toxicidad pulmonar aguda es rara y provoca una mayor mortalidad. Se presenta un paciente de 61 años con fibrilación auricular persistente que, tras tratamiento por un mes con amiodarona vía oral a dosis baja de impregnación de 400 miligramos al día, desarrolló toxicidad pulmonar aguda secundaria al antiarrítmico confirmada por radiografía y tomografía. Su caso tuvo resolución después de la suspensión del fármaco y tratamiento con esteroides.
Authors:
Julio O Cabrera-Rego[1], José D Luzurriaga Navas[2], Alberto A Yanes Quintana[1]
Affiliation:
[1] Unidad de Cuidados Coronarios Intensivos, Hospital Manuel Fajardo, La Habana, Cuba
[2] Departamento de Imagenología, Hospital Manuel Fajardo, La Habana, Cuba
E-mail: jocabrera@infomed.sld.cu
Author address:
[1] Zapata y D, Vedado, Plaza de La Revolución La Habana, Cuba Código postal: 10400
Citation: Cabrera-Rego JO, Luzurriaga Navas JD, Yanes Quintana AA. Acute amiodarone pulmonary toxicity with low impregnation dose: case report. Medwave 2020;20(7):e7996 doi: 10.5867/medwave.2020.07.7996
Submission date: 16/1/2020
Acceptance date: 25/7/2020
Publication date: 14/8/2020
Origin: Not commissioned
Type of review: Amiodarone, Pulmonary fibrosis, Acute pulmonary toxicity
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- Expósito ME, Fernández V, San Miguel MT. Fibrosis pulmonar asociada a amiodarona. A propósito de un caso. Farm Hosp. 1995;19(6):371-3. [On line]. | Link |
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- Lohiya RV, Pethe MP. Early Recognition of Acute Pneumonitis in Amiodarone Treatment. Heart Views. 2018 Jul-Sep;19(3):109-113. | CrossRef | PubMed |
- Abuzaid A, Saad M, Ayan M, Kabach A, Haddad TM, Smer A, et al. Acute Amiodarone Pulmonary Toxicity after Drug Holiday: A Case Report and Review of the Literature. Case Rep Cardiol. 2015;2015:927438. | CrossRef | PubMed |
- Range FT, Hilker E, Breithardt G, Buerke B, Lebiedz P. Amiodarone-induced pulmonary toxicity--a fatal case report and literature review. Cardiovasc Drugs Ther. 2013 Jun;27(3):247-54. | CrossRef | PubMed |
- Lancha-Domínguez J, Ramírez-Sánchez MM, Páez-Rubio MI. Toxicidad pulmonar asociada a tratamiento con amiodarona. Rev Esp Casos Clin Med Intern (RECCMI). 2019; 4(2):57-60. | CrossRef |
- Schwaiblmair M, Berghaus T, Haeckel T, Wagner T, von Scheidt W. Amiodarone-induced pulmonary toxicity: an under-recognized and severe adverse effect? Clin Res Cardiol. 2010 Nov;99(11):693-700. | CrossRef | PubMed |
- Kharabsheh S, Abendroth CS, Kozak M. Fatal pulmonary toxicity occurring within two weeks of initiation of amiodarone. Am J Cardiol. 2002 Apr 1;89(7):896-8. | CrossRef | PubMed |
- Subban V, Kalidoss L, Lakshmanan A, Ajit MS. Acute amiodarone pulmonary toxicity in a patient with acute anterior wall myocardial infarction and ventricular tachycardia. Sahel Med J. 2013;16(4):165-7. | CrossRef |
- Bahena-López E, Bucio-Reta E, Bahena-López JP. Toxicidad pulmonar por amiodarona. Rev Invest Med Sur Mex. 2015;22(4):214-7. [On line]. | Link |
- Sánchez S, Zamora E, Hoyos N, Naranjo A, Al Nakeeb Z, Girón RM. Fibrosis pulmonar por amiodarona. Rev Patol Respir. 2006;9(2):77-80. [On line]. | Link |
- Jiménez López G, Alonso Orta I. Normas y procedimientos de trabajo del Sistema Cubano de Farmacovigilancia. La Habana: Ministerio de Salud Pública (MINSAP), Dirección Nacional de Medicamentos y Equipos Médicos; 2012.
Expósito ME, Fernández V, San Miguel MT. Fibrosis pulmonar asociada a amiodarona. A propósito de un caso. Farm Hosp. 1995;19(6):371-3. [On line]. | Link |Kaya SB, Deger S, Hacievliyagil SS, Aytemur ZA. Acute amiodarone toxicity causing respiratory failure. Rev Assoc Med Bras (1992). 2017 Mar;63(3):210-212. | CrossRef | PubMed |Singh VK, Maheshwari V. Acute Respiratory Distress Syndrome Complicated by Amiodarone Induced Pulmonary Fibrosis: Don't Let Your Guard Down. J Clin Diagn Res. 2017 Apr;11(4):UD01-UD02. | CrossRef | PubMed |Lohiya RV, Pethe MP. Early Recognition of Acute Pneumonitis in Amiodarone Treatment. Heart Views. 2018 Jul-Sep;19(3):109-113. | CrossRef | PubMed |Abuzaid A, Saad M, Ayan M, Kabach A, Haddad TM, Smer A, et al. Acute Amiodarone Pulmonary Toxicity after Drug Holiday: A Case Report and Review of the Literature. Case Rep Cardiol. 2015;2015:927438. | CrossRef | PubMed |Range FT, Hilker E, Breithardt G, Buerke B, Lebiedz P. Amiodarone-induced pulmonary toxicity--a fatal case report and literature review. Cardiovasc Drugs Ther. 2013 Jun;27(3):247-54. | CrossRef | PubMed |Lancha-Domínguez J, Ramírez-Sánchez MM, Páez-Rubio MI. Toxicidad pulmonar asociada a tratamiento con amiodarona. Rev Esp Casos Clin Med Intern (RECCMI). 2019; 4(2):57-60. | CrossRef |Schwaiblmair M, Berghaus T, Haeckel T, Wagner T, von Scheidt W. Amiodarone-induced pulmonary toxicity: an under-recognized and severe adverse effect? Clin Res Cardiol. 2010 Nov;99(11):693-700. | CrossRef | PubMed |Kharabsheh S, Abendroth CS, Kozak M. Fatal pulmonary toxicity occurring within two weeks of initiation of amiodarone. Am J Cardiol. 2002 Apr 1;89(7):896-8. | CrossRef | PubMed |Subban V, Kalidoss L, Lakshmanan A, Ajit MS. Acute amiodarone pulmonary toxicity in a patient with acute anterior wall myocardial infarction and ventricular tachycardia. Sahel Med J. 2013;16(4):165-7. | CrossRef |Bahena-López E, Bucio-Reta E, Bahena-López JP. Toxicidad pulmonar por amiodarona. Rev Invest Med Sur Mex. 2015;22(4):214-7. [On line]. | Link |Sánchez S, Zamora E, Hoyos N, Naranjo A, Al Nakeeb Z, Girón RM. Fibrosis pulmonar por amiodarona. Rev Patol Respir. 2006;9(2):77-80. [On line]. | Link |Jiménez López G, Alonso Orta I. Normas y procedimientos de trabajo del Sistema Cubano de Farmacovigilancia. La Habana: Ministerio de Salud Pública (MINSAP), Dirección Nacional de Medicamentos y Equipos Médicos; 2012. 
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