Difficult cases in heart failure: amiodarone lung injury: another heart failure mimic?
Careful thought must be given to the development of bystander pathology that could mimic worsening of heart failure. Recent trials with patients receiving amiodarone record a low rate of amiodarone pulmonary toxicity of 1.6%. Bronchoalveolar lavage in amiodarone toxicity demonstrates an absolute and relative lymphocytic alveolitis, suggesting hypersensitivity, but this finding is neither sensitive nor specific. Recently, KL-6, a mucin-like high molecular weight glycoprotein secreted by proliferating type II alveolar pneumocytes, has been identified as a potential marker of interstitial pneumonitis. A high index of suspicion combined with rapid exclusion of common confounding mimics can help in establishing the diagnosis of amiodarone lung toxicity.
Sangha
Sumandeep
S
Ochsner Cardiomyopathy and Heart Transplantation Center, Ochsner Clinic Foundation, New Orleans, LA 70121, USA.
Uber
Patricia A
PA
Mehra
Mandeep R
MR
D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone