Bronchial pigmentation as a manifestation of amiodarone pulmonary toxicity

Numerous well-recognized manifestations of amiodarone pulmonary toxicity have been described since the advent of this medication for the treatment of cardiac arrhythmias. The typical presentation is a subacute infiltrative lung illness with bilateral infiltrates that develops within several years of treatment onset. We describe a previously unrecognized complication of long-term amiodarone use, characterized by cough and black airway pigmentation that resolved with discontinuation of amiodarone.