CTICasesAmiodarone-Induced Pleural Effusion
Imaging findings
Chest radiograph and subsequent chest CT demonstrate new, moderate bilateral pleural effusions (larger on the right) and mild associated pleural thickening, in a patient with history of atrial fibrillation on amiodarone. Thoracentesis confirms the fluid is exudative, meeting Light's criteria. Follow-up chest radiographs obtained after the discontinuation of amiodarone show complete resolution of both the effusions and the pleural thickening.
Key takeaways
Pleural effusion is an uncommon and underrecognized manifestation of amiodarone toxicity, usually presenting as an exudative effusion. When a patient on amiodarone develops a new pleural effusion without evidence of worsening left ventricular dysfunction or heart failure, amiodarone-induced pleural toxicity should be included in the differential diagnosis. Discontinuation of the drug typically leads to complete resolution of the effusions and pleural abnormalities.
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