A 70-year-old woman with acute history of fever, cough and myalgia, presented to our emergency department. Her previous significant medical history was mild hypertension and acute type A aortic dissection. He had been receiving amiodarone (400 mg/day) for refractory atrial fibrillation 1 year prior to symptom onset. A chest X-ray showed bilateral perihilar infiltrates and diffuse reticular shadow ( Figure 1A) . A plain computed tomography (CT) showed diffuse bilateral ground-glass opacities,

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... l consolidations in the lungs and increased attenuation with 80-110 Hounsfield units (normal range 30-70 HU) in the liver ( Figure 1B and C). Based on the clinical and characteristic radiographic findings, we made a diagnosis of amiodarone-induced pneumonitis. Her pulmonary symptoms deteriorated progressively and treated with prednisolone with mechanical ventilation in the intensive care unit. Three weeks after withdrawal from amiodarone, her pulmonary symptoms improved gradually. Amiodarone is widely used for the treatment of cardiac arrhythmias, but sometimes causes adverse effect for various organs. The risk of developing adverse effect is associated with the serum amiodarone accumulation. 1 Amiodarone induced pneumonitis is the most serious lifethreatening complication with mortality rate between 21-33%. 2 Long term amiodarone administration also hepatotoxicity due to iodine accumulation in the liver. The deposition of iodine increases liver attenuation on CT. Therefore, when a patient taking long-term amiodarone for cardiac arrhythmia with progressive pulmonary symptom with the characteristic radiographic findings is present, clinicians should consider amiodarone-induced pneumonitis as a possible differential diagnosis and withdrawing amiodarone immediately. Photographs and text from: Conflict of interest. None declared. Figure 1. (a) A chest X-ray revealed bilateral perihilar infiltrates and diffuse reticular shadow. (B) Non-enhanced CT showed reticular and diffuse ground-glass opacities and bilateral opal consolidations in the lungs. (C) Non-enhanced CT revealed abnormally high density with attenuation in the liver.