PT - JOURNAL ARTICLE AU - Mathieu Salaün AU - Francis Roussel AU - Geneviève Bourg-Heckly AU - Christine Vever-Bizet AU - Stéphane Dominique AU - Anne Genevois AU - Vincent Jounieaux AU - Gérard Zalcman AU - Emmanuel Bergot AU - Jean-Michel Vergnon AU - Luc Thiberville TI - <em>In vivo</em> probe-based confocal laser endomicroscopy in amiodarone-related pneumonia AID - 10.1183/09031936.00191911 DP - 2013 Dec 01 TA - European Respiratory Journal PG - 1646--1658 VI - 42 IP - 6 4099 - http://erj.ersjournals.com/content/42/6/1646.short 4100 - http://erj.ersjournals.com/content/42/6/1646.full SO - Eur Respir J2013 Dec 01; 42 AB - Probe-based confocal laser endomicroscopy (pCLE) allows microscopic imaging of the alveoli during bronchoscopy. The objective of the study was to assess the diagnostic accuracy of pCLE for amiodarone-related pneumonia (AMR-IP). Alveolar pCLE was performed in 36 nonsmoking patients, including 33 consecutive patients with acute or subacute interstitial lung disease (ILD), of which 17 were undergoing treatment with amiodarone, and three were amiodarone-treated patients without ILD. Nine out of 17 patients were diagnosed with high-probability AMR-IP (HP-AMR-IP) by four experts, and three separate observers. Bronchoalveolar lavage findings did not differ between HP-AMR-IP and low-probability AMR-IP (LP-AMR-IP) patients. In HP-AMR-IP patients, pCLE showed large (&gt;20 μm) and strongly fluorescent cells in 32 out of 38 alveolar areas. In contrast, these cells were observed in only two out of 39 areas from LP-AMR-IP patients, in one out of 59 areas from ILD patients not receiving amiodarone and in none of the 10 areas from amiodarone-treated patients without ILD (p&lt;0.001; HP-AMR-IP versus other groups). The presence of at least one alveolar area with large and fluorescent cells had a sensitivity, specificity, negative predictive value and positive predictive value for the diagnosis of AMR-IP of 100%, 88%, 100% and 90%, respectively. In conclusion, pCLE appears to be a valuable tool for the in vivo diagnosis of AMR-IP in subacute ILD patients. Probe-based confocal laser endomicroscopy appears useful for diagnosis of amiodarone-related pneumonia in subacute ILD http://ow.ly/ongMj