Sudden withdrawal of steroids in patients on long-term amiodarone therapy may trigger severe acute respiratory distress syndrome due to amiodarone-induced pneumonitis.
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Supports cautious steroid tapering during amiodarone therapy; single case leaves open need for prospective confirmation.
Acute lung toxicity is a rare but classical complication of amiodarone therapy. We report the case of a patient who developed an optic neuropathy after 15 years of amiodarone administration, and who was treated for 2 weeks with steroids. Following withdrawal of steroids, the patient rapidly developed an acute respiratory distress syndrome. Postmortem lung histologic examination was consistent with amiodarone-induced pneumonitis. Since this complication is thought to be of immunological origin, we speculate that the sudden withdrawal of steroids was implicated in the development of the acute lung injury.
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Charles et al. (2005) studied this question.
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