PURPOSE: The reported clinical features and outcome of the patients with statin-induced lung injury vary widely. In this study, we liked to explore the clinical data relevant to the diagnosis and outcome of the disease.
METHODS: Four cases of statin-induced lung injury diagnosed at our institute and 12 cases reported in English literature were studied. The 16 patients were further divided into favorable or unfavorable outcome groups based on the outcome.
RESULTS: Compared to the reported 12 cases, fever (p = 0.008) and consolidation (p = 0.027) were found more frequently and duration of statin treatment was significantly shorter (p = 0.030) in our four patients. Foamy appearance of the majority of alveolar macrophages in bronchoalveolar lavage fluid was found in our four patients. The patients with cough (p = 0.024), fever (p = 0.026), and alveolar infiltrates (p = 0.036) especially ground-glass opacity (GGO) (p = 0.001) shown on thoracic high resolution computed tomography (HRCT) had favorable outcome. Conversely, those with high blood level of autoantibodies (p = 0.030) and fibrosis shown on HRCT (p = 0.008) had unfavorable outcome. After stepwise logistic regression analysis, cough (p = 0.011), fever (p = 0.005), and alveolar infiltrate (p = 0.017), GGO (p < 0.001) and fibrosis (p = 0.002) shown on HRCT were independent factors for affecting the outcome of statin-induced lung injury.
CONCLUSIONS: The results indicated that pulmonary phospholipidosis as shown by foamy appearance of alveolar macrophages in lavage fluid might be of value in aiding a diagnosis of statin-induced lung injury. Clinical symptoms and thoracic HRCT findings may be of value in predicting the outcome of the disease. Further studies are needed to verify these issues.
CLINICAL IMPLICATIONS: Pulmonary phospholipidosis as shown by foamy appearance of the majority of alveolar macrophages in lavage fluid may be of value in aiding a diagnosis of statin-induced lung injury. Clinical symptoms and thoracic HRCT findings may be of value in predicting the outcome of the disease.
DISCLOSURE: The following authors have nothing to disclose: Han-Chen Tsai, Li-Kuo Huang, Fang-Chi Lin, Shi-Chuan Chang
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