Once APT is recognized, the first action is to have the patient stop taking amiodarone, followed by the administration of corticosteroids (eg, prednisone 40 to 60 mg/d11) for four to 12 months.17 Patients, especially those with underlying lung disease, will typically require temporary oxygen supplementation until hypoxia resolves. Even after the drug has been discontinued, some patients experience worsening symptoms before they see improvement simply because the drug can persist in lung tissue for up to a year following cessation of therapy.6
If APT is diagnosed early, the prognosis is favorable. In one study, a significant number of APT patients stabilized or improved after withdrawal of the drug, regardless of concurrent treatment with corticosteroids.18 Follow-up studies, both imaging and PFT, indicate complete clearing of lung opacities in the majority of patients treated for APT.19 Radiologic improvement may be seen six months after cessation of amiodarone.20 Patients who develop ARDS tend to do poorly and have a mortality rate of approximately 50%.11
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