Manolis A S, Tordjman T, Mack K D, Estes N A
Cardiac Electrophysiology Laboratory, Tufts/New England Medical Center, Boston, MA.
Arch Intern Med. 1987 Oct;147(10):1805-9.
Atypical manifestations of pulmonary toxicity and previously unreported autonomic nervous system dysfunction complicating amiodarone therapy were observed in a patient being treated for sustained ventricular tachycardia. Pulmonary and hepatic nodules on computed tomographic scan masquerading as metastatic carcinoma were initially noted. Focal infiltrates and a large left pleural effusion mimicking infection, malignant neoplasm, or collagen vascular disease became manifest at a later stage. Autonomic dysfunction presented as incapacitating orthostatic hypotension and persisted for six weeks after amiodarone withdrawal. The pleuropulmonary toxic effects were reversible on discontinuation of amiodarone therapy, and resolution was hastened by short-course steroid treatment.
在一名接受持续性室性心动过速治疗的患者中，观察到了肺毒性的非典型表现以及胺碘酮治疗并发的先前未报告的自主神经系统功能障碍。计算机断层扫描上的肺和肝结节最初被认为是伪装成转移性癌。后期出现了局灶性浸润和大量左侧胸腔积液，类似感染、恶性肿瘤或胶原血管疾病。自主神经功能障碍表现为使人丧失能力的直立性低血压，在停用胺碘酮后持续了六周。停用胺碘酮治疗后，胸膜肺毒性作用是可逆的，短期类固醇治疗加速了其消退。
