CTICasesAmiodarone Toxicity
Imaging findings
A chest radiograph shows patchy lung consolidation. CT reveals diffuse ground-glass opacities, crazy paving pattern, and perilobular consolidation in both lungs, with some areas more confluent. Soft tissue windows show increased attenuation of both the liver and the lung parenchyma. Surgical biopsy demonstrated organizing pneumonia and foamy macrophages.
Key takeaways
Amiodarone toxicity can manifest as an acute interstitial lung disease (e.g., organizing pneumonia, diffuse alveolar damage) and accumulation of the drug and its metabolites. Imaging findings can include ground-glass opacities, crazy paving, and consolidation. A characteristic feature is increased attenuation (density) of the liver and lung parenchyma. The condition is challenging to treat due to the prolonged half-life of amiodarone and its metabolites.
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