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Amiodarone Pulmonary Toxicity — RACP Adult Medicine MCQ

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ModerateRespiratoryAmiodarone Pulmonary ToxicityRACP Adult Medicine

A 55-year-old woman on amiodarone for 3 years presents with progressive dyspnoea and dry cough. HRCT shows bilateral ground-glass opacities with interlobular septal thickening. DLCO is reduced to 50% predicted. She has a high-attenuation liver on CT (consistent with amiodarone deposition). What is the most likely diagnosis?

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Correct answer: C — Drug-induced pneumonitis

Amiodarone pulmonary toxicity presents with progressive dyspnoea, ground-glass opacities with septal thickening, and reduced DLCO. The high-attenuation liver confirms amiodarone accumulation. Incidence is ~5% of patients on amiodarone. Treatment is drug cessation plus corticosteroids. Recovery may be slow due to amiodarone's extremely long half-life (40–55 days).

Reference: eTG Cardiovascular – 2024 – Amiodarone Toxicity; AMH 2025