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Amiodarone induced pulmonary fibrosis in infancy
P N Bowers1, J Fields, D Schwartz
1Section of Pediatric Cardiology, Yale University School of Medicine, New Haven, Connecticut, USA.
Insights
This study reports the first case of amiodarone-induced pulmonary fibrosis in an infant. Discontinuation of amiodarone led to the resolution of pulmonary fibrosis in this pediatric patient.
Area of Science:
- Pediatric Cardiology
- Pulmonology
- Clinical Pharmacology
Background:
- Atrioventricular reentrant tachycardia secondary to Wolff-Parkinson-White syndrome is a significant arrhythmia in infants.
- Amiodarone is an antiarrhythmic medication used to manage complex cardiac arrhythmias.
- Pulmonary fibrosis is a known, albeit rare, adverse effect of amiodarone in adults.
Observation:
- A 9-month-old infant, treated with amiodarone for intractable atrioventricular reentrant tachycardia, presented with asymptomatic diffuse interstitial infiltrates on chest radiography.
- The infant was otherwise thriving, with no respiratory symptoms despite radiographic evidence of lung disease.
Findings:
- The case represents the first documented instance of amiodarone-induced pulmonary fibrosis in the pediatric population.
- Following discontinuation of amiodarone, the infant's pulmonary fibrosis showed gradual resolution over a six-month period.
Implications:
- Increased use of amiodarone in pediatric patients for managing arrhythmias may lead to a rise in diagnosed cases of amiodarone-induced pulmonary fibrosis.
- Pediatricians and cardiologists should maintain a high index of suspicion for pulmonary complications in infants receiving amiodarone.
- Further research is warranted to understand the long-term implications and risk factors for amiodarone-induced pulmonary fibrosis in children.
Abstract:
We report a case of pulmonary fibrosis in an infant receiving amiodarone for treatment of intractable atrioventricular reentrant tachycardia secondary to Wolff-Parkinson-White syndrome. At 9 months, a screening chest radiograph showed a diffuse interstitial infiltrate in an asymptomatic, thriving infant. Amiodarone was discontinued and the pulmonary fibrosis resolved gradually over 6 months. This case documents the first report of amiodarone induced pulmonary fibrosis in the pediatric age group. We speculate that as amiodarone is used more frequently to manage pediatric arrhythmias, pulmonary fibrosis, a known complication of this antiarrhythmia in adults may be seen with increasing frequency in children.