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胺碘酮起始治疗后发生急性弥漫性肺泡出血1例罕见病例报告

A rare case of acute diffuse alveolar hemorrhage following initiation of amiodarone: a case report.

作者信息

Borders Charles W, Bennett Steven, Mount Cristin, Claassen Stephanie L

机构信息

Department of Internal Medicine, Keesler AFB Medical Center, MS 39534, USA.

出版信息

Mil Med. 2012 Jan;177(1):118-20. doi: 10.7205/milmed-d-11-00208.

Abstract

Amiodarone is effective for treating ventricular and supraventricular tachyarrhythmias, despite potential side effects which can include injury to the liver, thyroid, cornea, skin, and neuromuscular system. Acute lung toxicity is a known but rare side effect of amiodarone use, most commonly taking the form of an acute or subacute interstitial pneumonitis. Diffuse alveolar hemorrhage is a rare reaction, with few case reports documented in the literature since amiodarone became widely used in the early 1980s. We report the case of a patient who developed severe respiratory failure and diffuse alveolar infiltrates within 72 hours of initiating amiodarone therapy. Postmortem lung histology confirmed the diagnosis of diffuse alveolar hemorrhage. The case presentation and proposed mechanisms of action will be reviewed here.

摘要

胺碘酮对治疗室性和室上性快速心律失常有效,尽管其可能存在副作用,包括对肝脏、甲状腺、角膜、皮肤和神经肌肉系统的损伤。急性肺毒性是胺碘酮使用时已知但罕见的副作用,最常见的表现形式为急性或亚急性间质性肺炎。弥漫性肺泡出血是一种罕见的反应,自20世纪80年代初胺碘酮广泛使用以来,文献中记载的病例报告很少。我们报告一例患者,在开始胺碘酮治疗后72小时内出现严重呼吸衰竭和弥漫性肺泡浸润。尸检肺组织学检查确诊为弥漫性肺泡出血。本文将回顾该病例的临床表现及提出的作用机制。

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