A case of amiodarone-induced pulmonary toxicity recurring after steroid treatment
Kazuhiro Nagata Hiroomi Kuwahara Kazumasa Takenaka Sakiko Yura
Respiratory Center, Takeda Hospital
A 62-year-old man had been prescribed amiodarone for two years and seven months. He was referred to our hospital due to high KL-6 levels and a chest X-ray abnormality. A non-contrast computed tomography (CT) scan revealed patchy consolidations in both lung fields and increased attenuation of the liver. A drug lymphocyte stimulation test was positive for amiodarone. Transbronchial lung biopsy showed organizing pneumonia. Based on these findings, we diagnosed amiodarone-induced pulmonary toxicity. Steroid treatment led to improvement in chest radiography findings and was discontinued after three months. Two weeks after discontinuation of steroid treatment, chest radiography findings exacerbated, and increased attenuation of the liver remained. Steroid treatment was started again, which led to improvement. Thereafter, there were no further recurrences. At the end of treatment, attenuation of the liver had decreased to normal. We suggest that the level of attenuation of the liver on CT is a useful indicator for the treatment of amiodarone-induced pulmonary toxicity.
Amiodarone Drug-induced lung injury
Received 9 Aug 2017 / Accepted 10 Nov 2017
AJRS, 7(1): 54-58, 2018