Chest
Amiodarone Pneumonitis: Bronchoalveolar Lavage Findings in 15 Patients and Review of the Literature
Section snippets
PATIENTS AND METHODS
Inpatients and outpatients were recruited from the Departments of Pulmonary and Cardiovascular Diseases of the University Hospital of Dijon, Burgundy. Criteria for Am pneumonitis included the following: long-term (>2 months) treatment with Am, the notion of a normal chest roentgenogram prior to institution of Am therapy, development of new pulmonary opacities while receiving Am, absence of exposure to other pneumotoxicants, reasonable exclusion of other causes for the lung opacities (for the
Clinical Data—Chest Roentgenogram—Pulmonary Function
Fifteen patients (all male) with Am pneumonitis had their condition diagnosed between 1985 and 1991. Eight (patients 1, 3, 4, 6, 7, 8, 9, and 11) were reported earlier as a group in a letter to the editor in French,16 and one patient (patient 9) was described in the English literature.17 Six patients (patients 2, 3, 5, 7, 10, and 14) were never smokers, three (patients 11, 12, and 15) had stopped smoking more than one year earlier, while the six remaining patients (patients 1, 4, 6, 8, 9, and
DISCUSSION
The antiarrhythmic, amiodarone, enjoys popularity among cardiologists worldwide.3 Unfortunately, the drug induces numerous side effects,18 among is which pulmonary toxicity.2 Interestingly, pulmonary toxicity can be reproduced in laboratory animals.19 Despite a huge number of reported cases, no reliable predictive test or diagnostic criteria for Am pneumonitis has yet been identified.2, 20, 21 While an abnormal pretreatment chest roentgenogram or carbon monoxide diffusion test has been regarded
ACKNOWLEDGMENTS
The authors wish to thank Drs. M. Perrichon, A. Prud'homme, and P. Pfitzenmeyer for permission to study and to report details of patients under their care. Mrs. M. Lallemand and R. Trupin gave secretarial assistance. Grant 32* from l'Université de Bourgogne is gratefully acknowledged.
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