Amiodarone can cause atypical pulmonary toxicity mimicking malignancy or infection, as well as severe autonomic dysfunction, both of which are reversible upon discontinuation.
May support vigilance for atypical amiodarone toxicities; single case extends known reversible effects but remains hypothesis-generating.
Atypical manifestations of pulmonary toxicity and previously unreported autonomic nervous system dysfunction complicating amiodarone therapy were observed in a patient being treated for sustained ventricular tachycardia. Pulmonary and hepatic nodules on computed tomographic scan masquerading as metastatic carcinoma were initially noted. Focal infiltrates and a large left pleural effusion mimicking infection, malignant neoplasm, or collagen vascular disease became manifest at a later stage. Autonomic dysfunction presented as incapacitating orthostatic hypotension and persisted for six weeks after amiodarone withdrawal. The pleuropulmonary toxic effects were reversible on discontinuation of amiodarone therapy, and resolution was hastened by short-course steroid treatment.
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Antonis S. Manolis (1987) studied this question.
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