Amiodarone pneumonitis diagnosed by gallium-67 scintigraphy

A 75-year-old man presented with fever, dyspnoea, chest pain and findings suggestive of severe pneumonia including hypoxia and bilateral chest infiltrates. He was given antibiotics without significant effect. He took long-term amiodarone therapy for persistent atrial arrhythmias and also had a history of asbestosis with pre-existing pulmonary interstitial fibrosis. Pulmonary gallium-67 scintigraphy revealed extensive uptake of tracer throughout both lungs consistent with a diagnosis of amiodarone pneumonitis. Treatment of the drug reaction by drug withdrawal and corticosteroids resulted in marked clinical improvement. Pulmonary gallium-67 scintigraphy is a sensitive, but non-specific aid in the diagnosis of this drug effect. It proved valuable in our patient who additionally had asbestosis.