Statin-induced fibrotic nonspecific interstitial pneumonia.
Statins inhibit the 3-hydroxy-3-methylglutaryl coenzyme A reductase, reduce the serum level of low-density lipoprotein cholesterol, and are extensively prescribed to prevent cardiovascular mortality and morbidity. Few systemic adverse effects, such as pseudopolymyositis, lupus-like syndromes, and anecdotal hypersensitivity pneumonitis, have been reported. A simvastatin-induced diffuse interstitial pneumonia associated with a nonspecific interstitial pneumonia pattern at histological analysis is repoted here. Ultrastructural analysis showed a diffuse cytoplasmic accumulation of intralysosomial lamellar inclusions in type II pneumonocytes, histiocytes and endothelial cells, suggesting a shared pathogenesis with amphiphilic drug-induced toxic lung injury. Because statins are increasingly prescribed, statin-induced interstitial lung disorders may be more frequently observed and early recognition will be required.
Lantuejoul
S
S
Dept of Cellular Pathology, Centre Hospitalier Universitaire de Grenoble, Université J. Fourier, France.
Brambilla
E
E
Brambilla
C
C
Devouassoux
G
G
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D001707:Biopsy, Needle; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007150:Immunohistochemistry; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D019821:Simvastatin / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D000960:Hypolipidemic Agents; D019821:Simvastatin