title: Statin-induced lung injury: diagnostic clue and outcome.
abstract: BACKGROUND
  Statin-induced lung injury (SILI) is an uncommon but serious complication of statins. The clinical features and outcome of patients with SILI vary widely. Clinical data relevant to diagnosis and outcome of patients with SILI were investigated in this study.
  
  
  METHODS
  Four cases of SILI diagnosed at our institute and 12 cases reported in the English literature from 1995 to 2010 were studied. The patients were further divided into favourable and unfavourable outcome groups and compared.
  
  
  RESULTS
  Compared with the 12 previously reported cases, fever (p=0.008) and consolidation (p=0.027) were more common and duration of statin treatment was significantly shorter (p=0.030) in our patients. Foamy alveolar macrophages in bronchoalveolar lavage fluid (BALF) were found in our four patients. Patients with cough (p=0.024), fever (p=0.026) and alveolar infiltrates (p=0.036), especially ground-glass opacity (GGO) (p=0.001) shown on thoracic high-resolution CT (HRCT), had a favourable outcome. Conversely, those with fibrosis shown on HRCT (p=0.008) had an unfavourable outcome. Stepwise logistic regression analysis demonstrated that cough (p=0.011), fever (p=0.005), and alveolar infiltrates (p=0.017), GGO (p<0.001) and fibrosis (p=0.002) shown on thoracic HRCT were independent factors affecting the outcome of SILI.
  
  
  CONCLUSIONS
  For patients with SILI, pulmonary phospholipidosis, as shown by foamy alveolar macrophages in BALF, may be valuable in diagnosis, and clinical symptoms and thoracic HRCT findings are of value in predicting the outcome.
authors.affiliation: Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan.
authors.forename: Li-Kuo
authors.initials: LK
authors.lastname: Huang
authors.forename: Ming-Ji
authors.initials: MJ
authors.lastname: Tsai
authors.forename: Han-Chen
authors.initials: HC
authors.lastname: Tsai
authors.forename: Heng-Sheng
authors.initials: HS
authors.lastname: Chao
authors.forename: Fang-Chi
authors.initials: FC
authors.lastname: Lin
authors.forename: Shi-Chuan
authors.initials: SC
authors.lastname: Chang
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D008168:Lung / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology*; D055370:Lung Injury / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology*; D016676:Macrophages, Alveolar / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013624:Taiwan; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors