[Pneumopathy caused by amiodarone. An often unrecognized iatrogenic entity]

Area of Science:

• Cardiology
• Pulmonology
• Toxicology

Background:

• Amiodarone is a widely used anti-arrhythmic medication.
• Interstitial pneumonopathy is a known potential adverse effect of amiodarone therapy.
• Over 200 cases of amiodarone-induced lung injury have been previously reported.

Observation:

• This report details three additional cases of interstitial pneumonopathy linked to amiodarone use.
• Clinical, radiological, biological, and evolutive characteristics were reviewed.
• Bronchioalveolar lavage is highlighted for its therapeutic advantages.

Findings:

• Predisposing factors may include high dosage, long-term use, cumulative dose, and concurrent anti-arrhythmic use, particularly in elderly patients.
• Pre-existing reduced pulmonary function (total lung capacity and CO transfer capacity <80%) may increase risk.
• Discontinuation of amiodarone combined with steroid administration typically results in swift clinical and radiological improvement.

Implications:

• Awareness of risk factors is crucial for early identification of patients susceptible to amiodarone-induced lung disease.
• Prompt intervention, including drug cessation and corticosteroid therapy, can effectively manage and reverse amiodarone-related interstitial pneumonopathy.
• Further research is warranted to definitively establish predisposing factors and optimize patient management strategies.