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

BMJ Case Rep. 2019 Oct 25;12(10):e232149. doi: 10.1136/bcr-2019-232149.

Abstract

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.

Keywords: arrhythmias; respiratory medicine; unwanted effects/adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amiodarone / adverse effects*
  • Anti-Arrhythmia Agents / adverse effects*
  • Diagnosis, Differential
  • Female
  • Hemorrhage / chemically induced*
  • Hemorrhage / diagnostic imaging
  • Hemorrhage / drug therapy
  • Humans
  • Lung Diseases, Interstitial / chemically induced*
  • Lung Diseases, Interstitial / diagnostic imaging
  • Lung Diseases, Interstitial / drug therapy
  • Radiography
  • Steroids / therapeutic use

Substances

  • Anti-Arrhythmia Agents
  • Steroids
  • Amiodarone