Acute Presentation of Amiodarone Toxicity with Pleural Involvement
Published: December 1, 2020 | DOI: https://doi.org/10.7860/JCDR/2020/45355.14325
Divya Ramachandran
, Jaicob Varghese
, Meera Haridas
, Rajesh Venkitakrishnan
,Jolsana Augustine
, Melcy Cleetus
1. Consultant, Department of Pulmonary Medicine, Rajagiri Hopital, Aluva, Kerala, India.
2. Senior Consultant and Head, Department of Critical Care Medicine, Rajagiri Hospital, Aluva, Kerala, India.
3. Consultant, Department of Critical Care Medicine, Rajagiri Hospital, Aluva, Kerala, India.
4. Senior Consultant and Head, Department of Pulmonary Medicine, Rajagiri Hopital, Aluva, Kerala, India.
5. Consultant, Department of Pulmonary Medicine, Rajagiri Hopital, Aluva, Kerala, India.
6. Consultant, Department of Pulmonary Medicine, Rajagiri Hopital, Aluva, Kerala, India.
Correspondence
Divya Ramachandran,
Consultant, Department of Pulmonary Medicine, Rajagiri Hospital, Aluva, Kerala,
India.
E-mail: div_nair2004@yahoo.co.in
Amiodarone is a frequently prescribed anti-arrhythmic drug which is used to treat ventricular and supraventricular tachyarrhythmia. Although it has excellent efficacy in controlling or preventing common arrhythmias, it is potentially associated with a variety of adverse effects, the most serious of these being pulmonary toxicity. Amiodarone-associated toxicities are usually seen in solid organs like lung, spleen and thyroid due to extension of its pharmacokinetic properties. The presentation is often subacute. Acute presentation with pleural involvement is distinctly uncommon in amiodarone toxicity and can pose diagnostic challenges. Here the case presented is of a 67 year old female with multiple co-morbidities on amiodarone therapy, who presented with massive pleural effusion and respiratory failure. Typical radiological findings along with exclusion of alternate causes with appropriate tests led to a diagnosis of amiodarone toxicity involving lung parenchyma, pleura, liver and other organs. She responded to withdrawal of drug, steroid therapy and supportive care.
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