Which drug is known to cause both BOOP and interstitial pneumonitis?

Which drug is known to cause both BOOP and interstitial pneumonitis?

• A. Amiodarone
• B. Methotrexate
• C. Azathioprine
• D. Hydralazine

Answer: (A)

Amiodarone can cause a range of pulmonary toxicities, and two patterns frequently described are bronchiolitis obliterans organizing pneumonia (BOOP) and interstitial pneumonitis. The drug’s high lipophilicity leads to accumulation in lung tissue, and risk rises with higher cumulative dose, older age, and preexisting lung disease. Clinically, patients may develop subacute dyspnea and dry cough, with imaging revealing bilateral diffuse interstitial or patchy alveolar infiltrates. BOOP manifests as organizing pneumonia with plug-like formations in the air spaces, often improving with corticosteroids after stopping the drug. Interstitial pneumonitis is a separate pattern that can also occur and may progress to fibrosis if not addressed. Because amiodarone is well known to produce both of these pulmonary toxicities, it is the best answer. While other drugs can cause lung injury, they do not classically present with both BOOP and interstitial pneumonitis.

Amiodarone can cause a range of pulmonary toxicities, and two patterns frequently described are bronchiolitis obliterans organizing pneumonia (BOOP) and interstitial pneumonitis. The drug’s high lipophilicity leads to accumulation in lung tissue, and risk rises with higher cumulative dose, older age, and preexisting lung disease. Clinically, patients may develop subacute dyspnea and dry cough, with imaging revealing bilateral diffuse interstitial or patchy alveolar infiltrates. BOOP manifests as organizing pneumonia with plug-like formations in the air spaces, often improving with corticosteroids after stopping the drug. Interstitial pneumonitis is a separate pattern that can also occur and may progress to fibrosis if not addressed. Because amiodarone is well known to produce both of these pulmonary toxicities, it is the best answer. While other drugs can cause lung injury, they do not classically present with both BOOP and interstitial pneumonitis.