Voulgareli Ilektra, Chronaiou Alexandra, Tsoukalas Dionisios, Tsoukalas George
Department of Pneumonology, Sotiria Hospital, Athens, Greece.
Pneumonia (Nathan). 2018 Dec 5;10:12. doi: 10.1186/s41479-018-0056-3. eCollection 2018.
We report a case of endogenous lipoid pneumonia secondary to long-term use of amiodarone (> 30 years) for atrial fibrillation in a 76-year-old Caucasian woman, presenting with cough and dyspnea. Endogenous Lipoid pneumonia is a rare underdiagnosed condition more prevalent in adults. It is usually asymptomatic and a diagnosis is generally made in patients who have become clinically unstable or when an abnormal lung shadow is found on a chest X-ray. In the case here described it was diagnosed by fiberoptic bronchoscopy with bronchoalveolar lavage (BALF) where fat-laden macrophages (oil red O stain) were identified. Since a history of use of oil-based products had been ruled out, amiodarone was deemed to be the most likely cause of lipoid pneumonia. The patient was managed with the replacement of amiodarone with digoxin and treated with oral prednisolone. The patient has remained clinically stable with radiological improvement during a follow-up of two years.
我们报告了一例76岁白人女性因长期（超过30年）使用胺碘酮治疗房颤继发的内源性类脂性肺炎，该患者表现为咳嗽和呼吸困难。内源性类脂性肺炎是一种罕见的、诊断不足的疾病，在成年人中更为常见。它通常无症状，一般在患者出现临床不稳定或胸部X光发现肺部异常阴影时才得以诊断。在本文所述病例中，通过纤维支气管镜检查及支气管肺泡灌洗（BALF）确诊，其中发现了充满脂肪的巨噬细胞（油红O染色）。由于已排除使用油基产品的病史，胺碘酮被认为是类脂性肺炎最可能的病因。该患者停用胺碘酮改用 digoxin 治疗，并口服泼尼松龙。在两年的随访中，患者临床症状保持稳定，影像学表现有所改善。
