Too Little, Too Late: A Case of a Swift Fatal Culmination of Amiodarone Induced Pulmonary Toxicity in an Adult Male

Abstract

Amiodarone is a commonly prescribed antiarrhythmic drug. It can cause a myriad of complications associated with its long-term use, with amiodarone induced pulmonary toxicity being the worst. Amiodarone does this through its destructive properties and its’ ability to accumulate if taken for extended periods of time or in high cumulative doses. Albeit uncommon, the management of amiodarone induced pulmonary toxicity can be straightforward if recognized early. Otherwise, it can lead to severe respiratory failure causing death. In this case report, we aim to highlight the importance of vigilance with clinicians prescribing amiodarone and to spark interests into research for alternative management options of amiodarone induced pulmonary toxicity. This will be done through the description of a case of a 64-year-old male presenting with cough and dyspnoea, who has been on a large dose of amiodarone daily for the past 11 months. He was diagnosed too little, too late, which unfortunately culminated in his rapid fatality. This case is unique for two reasons. The diagnosis of amiodarone induced pulmonary toxicity was through the clinical picture – without the use of invasive investigations. In addition, the futile cessation of amiodarone and use of high dose systemic corticosteroids as a management – which to our knowledge is uncommon in literature.

Keywords:

• amiodarone
• amiodarone induced pulmonary toxicity

Data Sharing Statement

All data and findings generated or analyzed during this study are included in this published article.

Ethics Approval and Consent to Participate

Full and written informed consent was obtained from the next of kin of this patient. This case report was conducted and written in accordance with the Townsville Hospital and Health Service Human Research Ethics Committee (EX/2023/QTHS/101997) (Approved and endorsed on the 18th September 2023). No institutional approval was required for the publishing of this case report.

Consent for Publication

The next of kin of this patient and medical personnel involved in the care of the patient have given a full and written consent in line for the publication of this case report which would include the use of clinical details, investigation findings, and various discussions which have occurred.

Author Contributions

Conception and design of the report and approval of the version of the manuscript to be published: CT and PK. Acquisition of data: CT. Drafting the manuscript: CT. Revising the manuscript for intellectual content: CT. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest in this work.

Additional information

Funding

This case report received no funding at any point in time.