[Recurrent alveolitis caused by amiodarone]

Area of Science:

• Cardiology
• Pulmonology
• Pharmacology

Background:

• Amiodarone is an effective antiarrhythmic drug.
• Pulmonary toxicity is a known adverse effect of amiodarone.
• Few cases of amiodarone pulmonary toxicity recurrence have been reported.

Observation:

• A 54-year-old woman developed pulmonary alveolitis with diffuse infiltrates after 6 months of amiodarone treatment.
• Pulmonary symptoms recurred 17 months after amiodarone discontinuation and corticosteroid therapy cessation.
• Persistent amiodarone levels were detected in bronchoalveolar lavage fluid during recurrence.

Findings:

• This case details an unusual recurrence of amiodarone-induced pulmonary toxicity.
• Complete resolution of pulmonary symptoms was achieved only after 20 months from the initial amiodarone cessation.
• Persistent amiodarone levels in bronchoalveolar lavage may indicate prolonged lung tissue exposure.

Implications:

• Clinicians should be aware of the potential for late recurrence of amiodarone pulmonary toxicity.
• Long-term monitoring may be necessary even after drug discontinuation.
• Further research is needed to understand the mechanisms of amiodarone pulmonary toxicity recurrence.