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.
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.
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.
Amiodarone is more commonly used in clinical settings and therefore the pulmonary toxicity of the drug becomes a more frequent problem.
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.
J. Homolka, None.