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Clinical Picture of Amiodarone Pneumonitis 2000-2003 FREE TO VIEW

Jiri Homolka, MD*; Lenka Svobodova, MD; Alena Slovakova, MD; Vladimir Votava, MD; Pavla Stranska, MD
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1st Lung Department, Charles University, Prague, Czech Republic


Chest


Chest. 2004;126(4_MeetingAbstracts):754S. doi:10.1378/chest.126.4_MeetingAbstracts.754S-b
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Abstract

PURPOSE:  Amiodarone is an effective antiarrhytmic agent used to treat serious cardiac arrhytmias. Its pulmonary toxicity may represent a serious health problem and may even cause a death of a patient. The aim of our study was to prospectively evaluate the clinical picture of amiodarone pneumonitis in patients admitted to our Department in 2000-2003.

METHODS:  Starting January 2000 the patients with possible amiodarone pneumonitis on the basis of clinical symptoms, chest X-ray and HRCT criteria, pulmonary function tests and BAL findings were enrolled into the study.

RESULTS:  Since 1/1/2000 12 patients have been enrolled, three females and 9 males with average age 69±10.4 years. The frequency of amiodarone pneumonitis increased during the followed period. The most common symptoms were cough and dyspnea. The average daily dose of the drug varied between 100-400 mg, the duration of administration varied from 2 to 72 months. The normal ventilatory parameters (TLC/mean±SD/79±12%pred, FVC/mean±SD/82±11%pred) with moderately reduced DLco/mean± SD/49±10%pred have been observed. Chest X-ray and HRCT scans showed patchy infiltrative, nodular and reticular changes. BAL finding were characterized by lymphocytic alveolitis (Ly 26±21%) with predominance of CD8+T-cells (IRI 0.4±0.2). The most frequent treatment option was the discontinuation of the drug, in two subjects steroids were also added.

CONCLUSION:  Amiodarone is more commonly used in clinical settings and therefore the pulmonary toxicity of the drug becomes a more frequent problem.

CLINICAL IMPLICATIONS:  Amiodarone represents an effective antiarrhytmic agent which may cause a serious lung damage by different pathogenetic mechanisms. Supported by a Grant from Ministry of Education, Youth and Physical Training MSMT 111100005.

DISCLOSURE:  J. Homolka, None.

Tuesday, October 26, 2004

12:30 PM- 2:00 PM


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