Lung
Other nonneoplastic conditions
Drug reactions
Amiodarone induced pulmonary toxicity
Author: Elliot Weisenberg, M.D.
Last author update: 1 September 2011
Last staff update: 28 September 2020
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed search: amiodarone pulmonary toxicity
Table of Contents
Definition / general | Case reports | Treatment | Microscopic (histologic) description | Cytology description | Electron microscopy descriptionCite this page: Weisenberg E. Amiodarone induced pulmonary toxicity. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lungnontumoramiodarone.html. Accessed December 25th, 2024.
Definition / general
- Oral antiarrythmic drug, usually used long term
- 5% - 10% of patients develop lung injury
- Risk factors are: advanced age, higher dose therapy, lung surgery, oxygen therapy and underlying pulmonary disease; disease may occur without risk factors or at lower doses
- Drug inhibits phospholipid degradation by lysosomes, resulting in phospholipid accumulation within cells, especially alveolar macrophages
Case reports
- 68 year old man with amiodarone induced pulmonary toxicity (Arch Pathol Lab Med 2002;126:745)
Treatment
- Drug withdrawal or dose reduction, corticosteroid therapy
- May have 50% mortality if diffuse alveolar damage is present
Microscopic (histologic) description
- Intra-alveolar exudate of finely vacuolated foamy macrophages, also present within alveolar septa
- May have diffuse alveolar damage, cryptogenic organizing pneumonia type changes or changes of nonspecific interstitial pneumonia or desquamative interstitial pneumonia
Cytology description
- Finely vacuolated, foamy macrophages; variable neutrophils
Electron microscopy description
- Membrane bound cytoplasmic lamellar inclusions due to drug accumulation in the lungs
- Morphologic findings are not specific and must be interpreted in conjunction with the clinical history
