Amiodarone-induced pulmonary toxicity (APT): A low dose fatal adverse event

Introduction: Amiodarone pulmonary toxicity (APT) can be a diagnostic challenge to clinicians as it has no pathognomonic clinical, laboratory, radiological or histological features. It can potentially be fatal particularly in high risk patients. Amiodarone pulmonary toxicity is dose dependent, however, low dosages have also been reported to cause severe pulmonary disease. Therefore, it should be considered in every patient with respiratory distress and on current or recent amiodarone therapy. Case Report: We report a case of APT with fatal outcome in a 49-year-old female taking the recommended doses of amiodarone with history of atrial fibrillation, rheumatic heart disease and pulmonary hypertension. Our patient was taking amiodarone for three years. She presented with severe respiratory distress necessitating endotracheal intubation. Despite treatment with systemic corticosteroids and broad spectrum antimicrobials, patient died in intensive care unit (ICU) after one month of admission. Amiodarone pulmonary toxicity is usually dose-dependent, however, our patient was taking safe doses which make this case unique. Conclusion: The knowledge of different safe dosage patterns is important for every working physician due to widely usage of the drug. The lowest effective dose of amiodarone should be determined for every patient requiring long-term treatment and needs a close and regular follow-up for early diagnosis of lung injury. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 7 No. 4, April 2016. ISSN – [0976-3198] Int J Case Rep Imag 2016;7(4):282–286. www.ijcasereportsandimages.com Butt et al. 282 CASE REPORT OPEN ACCESS Amiodarone-induced pulmonary toxicity (APT): A low dose fatal adverse event Muhammad Imran Butt, Muhammad Asif Shahzad