Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication

Amiodarone is an antiarrhythmic agent that is used commonly in clinical practice. It is associated with many side effects, the most common being pulmonary manifestations. Interstitial pneumonitis is one of the most common complications, however rarely amiodarone can cause diffuse alveolar haemorrhag...

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Bibliographic Details
Published in:BMJ case reports 2019-10, Vol.12 (10), p.e232149
Main Authors: Saeed, Jamaluddin, Waqas, Qazi Ahmed, Khan, Uzma Ikhtiar, Abdullah, Hafez Mohammad Ammar
Format: Article
Language:English
Subjects:
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Amiodarone - adverse effects
Anti-Arrhythmia Agents - adverse effects
Antigens
Cardiac arrhythmia
Cardiovascular disease
Case reports
Coronary vessels
Diagnosis, Differential
Drug dosages
Edema
Family medical history
Female
Heart failure
Hemorrhage
Hemorrhage - chemically induced
Hemorrhage - diagnostic imaging
Hemorrhage - drug therapy
Humans
Lung diseases
Lung Diseases, Interstitial - chemically induced
Lung Diseases, Interstitial - diagnostic imaging
Lung Diseases, Interstitial - drug therapy
Patients
Pneumonia
Radiography
Respiratory diseases
Steroids - therapeutic use
Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions
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Summary:Amiodarone is an antiarrhythmic agent that is used commonly in clinical practice. It is associated with many side effects, the most common being pulmonary manifestations. Interstitial pneumonitis is one of the most common complications, however rarely amiodarone can cause diffuse alveolar haemorrhage (DAH) too. We describe the case of a 73-year-old woman who presented with shortness of breath and haemoptysis 4 days after starting amiodarone. She was diagnosed with amiodarone-induced DAH based on imaging and bronchoalveolar lavage. She was treated with intravenous and then oral steroids, and amiodarone was discontinued. The patient made a significant clinical and radiological recovery. She was discharged 10 days after her presentation. This case highlights a rare but potentially life-threatening complication of a commonly used medication.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2019-232149