Rapid tapering of glucocorticoids in the treatment of amiodarone-induced pulmonary toxicity can lead to severe recurrent pulmonary complications including alveolar hemorrhage.
Caution with rapid glucocorticoid tapers in amiodarone pulmonary toxicity; case report leaves open optimal withdrawal strategies.
Introduction Amiodarone is a commonly used drug for the treatment of cardiac arrhythmias. It has a broad range of toxicity including photosensitivity, blue-gray discoloration of the skin, thyroid dysfunction, corneal deposits, abnormal liver function tests, and bone marrow suppression. 1 Pulmonary toxicity is the most serious adverse effect of amiodarone. Treatment of amiodaroneinduced pulmonary toxicity includes discontinuation of the drug and initiation of glucocorticoid therapy in the majority of symptomatic patients. This case of recurrent amiodarone toxicity was manifested by acute interstitial pneumonitis and diffuse alveolar hemorrhage after a rapid taper of glucocorticoids.
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Jambeih et al. (2010) studied this question.
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