Amiodarone Pulmonary Toxicity: A Patient with Three Recurrences of Pulmonary Toxicity and Consideration of the Probable Risk for Relapse

• Published in: Internal Medicine Vol. 45; no. 22; pp. 1303 - 1307
• Main Authors: Okayasu, Kaori, Takeda, Yuichiro, Kojima, Jun, Yoshizawa, Atsuto, Kobayashi, Nobuyuki, Sugiyama, Haruhito, Kudo, Koichiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2006
• Subjects: Adult; Amiodarone - adverse effects; Amiodarone - therapeutic use; amiodarone-induced interstitial pneumonia; Anti-Arrhythmia Agents - adverse effects; Anti-Arrhythmia Agents - therapeutic use; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - therapeutic use; Body Mass Index; Cardiomyopathy, Dilated - drug therapy; Cardiomyopathy, Dilated - pathology; Dose-Response Relationship, Drug; Humans; lipophilic; Lung Diseases, Interstitial - chemically induced; Lung Diseases, Interstitial - diagnostic imaging; Lung Diseases, Interstitial - drug therapy; Male; Prednisolone - administration & dosage; Prednisolone - therapeutic use; Radiography, Thoracic; Recurrence; relapse; Retreatment; Tomography, X-Ray Computed
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.45.1800

A 44-year-old man was treated with amiodarone for dilated cardiomyopathy. After 53 months, he developed amiodarone-induced interstitial pneumonia. Amiodarone treatment was terminated, and the patient was given corticosteroids. These treatments were effective. However, pneumonitis recurred whenever prednisolone was reduced to less than 5 mg per day. Considering the patient's background characteristics, we considered his body mass index (BMI, kg/m2) and found his to be high. When four additional patients with amiodarone pulmonary toxicity were reviewed at our institute, a correlation between BMI and the duration of shadow disappearance was found (R2=0.8695). Because amiodarone is lipophilic, the patient's high BMI might have influenced the repeated appearance of pulmonary toxicity.