Amiodarone pulmonary toxicity: a patient with three recurrences of pulmonary toxicity and consideration of the probable risk for relapse.

A 44-year-old man was treated with amiodarone for dilated cardiomyopathy. After 53 months, he developed amiodarone-induced interstitial pneumonia. Amiodarone treatment was terminated, and the patient was given corticosteroids. These treatments were effective. However, pneumonitis recurred whenever prednisolone was reduced to less than 5 mg per day. Considering the patient's background characteristics, we considered his body mass index (BMI, kg/m(2)) and found his to be high. When four additional patients with amiodarone pulmonary toxicity were reviewed at our institute, a correlation between BMI and the duration of shadow disappearance was found (R(2)=0.8695). Because amiodarone is lipophilic, the patient's high BMI might have influenced the repeated appearance of pulmonary toxicity.