The Drug-Induced Respiratory Disease Website

Amiodarone

Relapsing or migrating pneumonitis/pneumonia (see also Id)

May occur as a manifestation of amiodarone-associated BOOP, if corticosteroids are tapered 'too early' (even after some months of steroid treatment) as a manifestation of extended storage of amiodarone in the tissue

Publications

Joelson J, Kluger J, Cole S, Conway M

Possible recurrence of amiodarone pulmonary toxicity following corticosteroid therapy.

Chest 1984 Feb;85;284-6 — 1984 Feb — 284-6

Scardi S, Ciani F, Pandullo C, Padrini R, Pivotti F

[Recurrent alveolitis caused by amiodarone].

Giornale italiano di cardiologia 1986 Feb;16;177-80 — 1986 Feb — 177-80

Camus P, Lombard JN, Perrichon M, Piard F, Guérin JC, Thivolet FB, Jeannin L

Bronchiolitis obliterans organising pneumonia in patients taking acebutolol or amiodarone.

Thorax 1989 Sep;44;711-5 — 1989 Sep — 711-5

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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