Diagnostic accuracy of KL-6 as a marker of amiodarone-induced pulmonary toxicity.
The diagnostic accuracy of KL-6 as an indicator of amiodarone-induced pulmonary toxicity was studied in 14 men (mean age = 62 +/- 12, range 33-76 years) treated with amiodarone. The indications for amiodarone were sustained ventricular tachycardia in 13 patients and atrial fibrillation in 1 patient with refractory heart failure. The KL-6 cut-off level was set at 520 U/mL. Group A consisted of two patients with amiodarone-induced pulmonary toxicity, group B of five patients with other pulmonary disorders, and group C of seven patients without pulmonary disease. KL-6 levels, percent diffusing capacity for carbon monoxide (%DLCO), and other laboratory markers were compared among these three groups. KL-6 levels were significantly higher in group A than in group B and C (2550 +/- 36, 252 +/- 99, 198 +/- 82 U/mL, respectively; P < 0.0001). KL-6 levels in group B were below the cutoff value. %DLCO, C-reactive protein (CRP), and lactic dehydrogenase (LDH) were abnormal in group A. The abnormal rates of CRP and LDH in group B were 80% and 40%, respectively. Of the seven patients with pulmonary disease, three patients (43%) could not undergo %DLCO testing because of poor physical condition. In one patient with amiodarone-induced pulmonary toxicity, the KL-6 level increased from 695 to 2,100 U/mL at a time of progression of interstitial changes. KL-6 may be a useful marker of amiodarone-induced pulmonary toxicity.
Endoh
Y
Y
Department of Cardiology, Saisei-kai Kurihashi Hospital, Saitama, Japan. takumi@wa2.so-net.ne.jp
Hanai
R
R
Uto
K
K
Tanaka
T
T
Ohta
Y
Y
Kasanuki
H
H
Ohnishi
S
S
D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects*; D000941:Antigens / Q000097:blood*; D000951:Antigens, Neoplasm; D001281:Atrial Fibrillation / Q000097:blood / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D017563:Lung Diseases, Interstitial / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018396:Mucin-1; D009077:Mucins; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000097:blood / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
D000941:Antigens; D000951:Antigens, Neoplasm; D015415:Biomarkers; D006023:Glycoproteins; C060192:MUC1 protein, human; D018396:Mucin-1; D009077:Mucins; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase; D000638:Amiodarone