Clinic and radiologic features and outcomes of amidrone induced alveolities under the influence of steroid treatment

Abstract

The aim of the study wastoevaluateclinic and radiologic features and outcomes of amiodarone induced alveolities under the influence of treatment.

Materials and Methods: We have examined ]0 the clinical and radiographic data of 25 patients with the average age was 59, 2+6, 4 years. Length of amiodarone treatment differed from 2 month to 8,9 years. All patients underwent MDCT, SPECT –CT and pulmonary functional tests.

Results: we observed a complete regression of changes on CT - scans, improvement in respiratory function and diffusion capacity, no perfusion disorders revealed by SPECT in 16% of patients. In 84% of patients negative dynamics was observed: 20% developed recurrent exacerbations which were connected with lowering of the dose of glucucorticoid treatment; in 12% we determined vascular complications visualized by CT study and by SPECT (pulmonary embolism in small vessels); 12% of patients had regression of alveolar infiltration in the lungs, but developed of bronchial obstruction; 64% of patients had irreversible development of fibrotic changes of localization and severity In 12% of patients fibrotic changes were characterized by "honeycombing" with the presence of small-sized "cells", interlobular fibrosis with lesions predominantly localized in posterior subpleural regions.

Conclusions: Thus, in 84% of cases treatment with low-dose amiodarone induced unfavorable course and outcomes of amiodarone induced alveolities, despite the abolition of the drug and steroid therapy. CT scan is necessary in patints with new or worsening complaints for the earlier diagnosis of pulmonary complications.