Terra Filho M, Vargas F S, Cukier A, Teixeira L R, Pinto R M, Pileggi F
Arq Bras Cardiol. 1989 Oct;53(4):201-5.
Fifteen patients, eleven males and four females, with amiodarone induced pulmonary disease were studied. Their ages ranged between 52 and 79 (mean = 64.0) years. 66% of the patients were taking a daily dose of 200 mg of amiodarone. The time elapsed between the initial dose and the diagnosis of the pneumonitis varied from 2 to 84 (mean = 23.3) months. Premature ventricular beats and recurrent episodes of paroxistic supra ventricular tachycardia were the most common indications for the use of the drug. The most frequent clinical complaints were progressive dyspnea and cough. Weight loss was observed in five patients, fever in six and chest pain in two. The most habitual thoracic physical sign was diffuse crepitation. Chest roentgenograms disclosed bilateral interstitial infiltrates in all patients, associated to pleural effusions in two. An increased diffuse uptake of 67 gallium citrate was observed in the nine patients to whom it was done. Lung function tests showed a pattern of restrictive ventilatory respiratory insufficiency and hypoxemia. Lung tissue specimens were obtained in ten patients, bronchoalveolar lavage in one and pleural fluid in one. The material was examined by light and electron microscopy. Amiodarone was discontinued in all patients and corticosteroids were introduced in thirteen. Five patients (33.3%) died, eight improved and two remained with radiographic scars.
对15例胺碘酮所致肺部疾病患者进行了研究，其中男性11例，女性4例。他们的年龄在52岁至79岁之间（平均64.0岁）。66%的患者每日服用200毫克胺碘酮。从初始用药到肺炎诊断的时间间隔为2至84个月（平均23.3个月）。室性早搏和阵发性室上性心动过速反复发作是使用该药物最常见的指征。最常见的临床症状是进行性呼吸困难和咳嗽。5例患者出现体重减轻，6例发热，2例胸痛。最常见的胸部体征是弥漫性捻发音。胸部X线片显示所有患者均有双侧间质浸润，2例伴有胸腔积液。9例接受检查的患者镓-67枸橼酸盐摄取增加。肺功能测试显示为限制性通气呼吸功能不全和低氧血症模式。10例患者获取了肺组织标本，1例进行了支气管肺泡灌洗，1例获取了胸腔积液。材料进行了光镜和电镜检查。所有患者均停用胺碘酮，13例患者开始使用皮质类固醇。5例患者（33.3%）死亡，8例好转，2例遗留影像学瘢痕。
