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[胺碘酮超敏反应所致肺病及相关肾病。经肺泡灌洗研究]

[Pneumopathies caused by hypersensitivity to amiodarone and associated nephropathies. Study by alveolar lavage].

作者信息

Caubarrère I, Bonan G, Venet A, Chebat J, Uzzan D, Gilbert J, Beaufils H

出版信息

Ann Med Interne (Paris). 1985;136(4):311-5.

PMID:4037586
Abstract

Four cases of amiodarone-induced restrictive, hypoxaemic lung disease are described. The cumulative dosages of amiodarone were relatively low (30 to 100 g). Alveolar lavage studies showed a lymphocytosis and study of the lymphocytic sub-populations showed an increase in the OKT8 group, and an inversion of the OKT4/OKT8 ratio. The outcome was favourable on withdrawal of amiodarone and steroid therapy. The immunological origin of this form of lung disease was confirmed. Two patients had renal failure; in the first case, hypercalcaemia, hyperphosphoremia and renal calcification were observed. The second patient had endo- and extracapillary glomerulonephritis with C3 deposits and circulating immune complexes. Renal failure regressed in both cases on withdrawal of amiodarone and with steroid therapy.

摘要

本文描述了4例胺碘酮诱发的限制性低氧性肺病。胺碘酮的累积剂量相对较低(30至100克)。肺泡灌洗研究显示淋巴细胞增多,淋巴细胞亚群研究显示OKT8组增加,OKT4/OKT8比值倒置。停用胺碘酮和类固醇治疗后,预后良好。这种形式的肺病的免疫起源得到了证实。两名患者出现肾衰竭;第一例患者观察到高钙血症、高磷血症和肾钙化。第二例患者患有伴有C3沉积和循环免疫复合物的毛细血管内和外肾小球肾炎。停用胺碘酮并接受类固醇治疗后,两例患者的肾衰竭均得到缓解。

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