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Drug-induced pneumonitis — SCE Respiratory MCQ

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ModerateILDDrug-induced pneumonitisSCE Respiratory

A 66-year-old man treated with amiodarone for atrial fibrillation has progressive breathlessness and dry cough. HRCT shows bilateral high-attenuation peripheral consolidations and ground-glass change. TLCO has fallen from 78% to 48% predicted; infection work-up is negative. What is the most likely diagnosis?

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Correct answer: E — Amiodarone-induced lung toxicity

Amiodarone can cause interstitial pneumonitis or organising pneumonia with high-attenuation lung opacities due to iodine content. Pneumonia is less likely with progressive course and negative infection assessment. IPF would usually show a UIP fibrotic pattern rather than high-attenuation consolidation.

Reference: BNF; BTS ILD guidance