Fireman Elizabeth, Topilsky Ian, Viskin Sami, Priel Israel E
The Institute of Pulmonary and Allergic Diseases, Tel-Aviv Sourasky Medical Center, Tel Aviv, Tel-Aviv, Israel.
Cardiology. 2007;108(4):223-7. doi: 10.1159/000096782. Epub 2006 Nov 7.
Amiodarone, a highly effective medication for suppressing cardiac rhythm disturbances, may cause pulmonary injury, such as chronic interstitial lung diseases, in 5-15% of the patients who take it. We applied induced sputum (IS), a non-invasive technique, for diagnosing amiodarone-induced pulmonary toxicity. Four patients with interstitial lung disease who were treated by amiodarone for ischemic heart diseases were evaluated by a conventional clinical workup. All four patients showed marked interstitial pattern on computerized tomography and decreased diffusion capacity (DLCO-SB 51-76%). IS showed lymphocytosis, a high CD4 or CD8 count, eosinophilia and amiodarone in 3 of 4 patients. IS may be a useful tool for assessing amiodarone toxicity in patients with ischemic heart diseases and concomitant pulmonary side effects.
胺碘酮是一种用于抑制心律失常的高效药物,在服用该药物的患者中,5%至15%可能会出现肺部损伤,如慢性间质性肺病。我们应用诱导痰(IS)这一非侵入性技术来诊断胺碘酮所致的肺毒性。对4例因缺血性心脏病接受胺碘酮治疗的间质性肺病患者进行了常规临床检查。所有4例患者在计算机断层扫描上均显示出明显的间质模式,且弥散功能降低(单次呼吸一氧化碳弥散量[DLCO-SB]为51%至76%)。4例患者中有3例的诱导痰显示淋巴细胞增多、CD4或CD8计数升高、嗜酸性粒细胞增多以及存在胺碘酮。诱导痰可能是评估缺血性心脏病且伴有肺部副作用患者胺碘酮毒性的一种有用工具。