Amiodarone-induced loculated pleural effusion without pulmonary parenchymal involvement: A case report and literature review

Abstract

Amiodarone is an extremely effective antiarrhythmic drug that is known to cause many adverse effects such as pulmonary, thyroid, and liver toxicities. Of these, pulmonary toxicity is most serious. Pulmonary toxicity can present as interstitial pneumonitis, organizing pneumonia, pulmonary nodules and masses, and very rarely pleural effusions. We present a case of a 73-year-old male who presented with progressive exertional dyspnea, nonproductive cough, generalized fatigue, and weakness. He was found to have multiorgan toxicity secondary to long-term treatment with high doses of amiodarone. This case illustrates that amiodarone may cause toxicity involving multiple organs simultaneously in patients receiving long-term therapy and represents the first reported case of amiodarone-induced loculated pleural effusion without associated lung parenchymal involvement.

Acute respiratory failure on a low dose of amiodarone – is it an underdiagnosed and undertreated condition?

“…Right-sided pleural effusion seen in our patient was the manifestation of acute decompensated heart failure precipitated with an ARDS. However, Hawatmeh, et al reported a case of an amiodarone-induced pleural effusion without associated lung parenchymal involvement in a 73-year-old male with a history of coronary artery disease [ 16 ]. Uong et al also reported a case of an amiodarone-induced bilateral pleural effusion without associated pneumonitis in a 70-year old female patient with a history of atrial fibrillation [ 17 ].…”