title: Initial characteristics and outcome of hospitalized patients with amiodarone pulmonary toxicity.
abstract: Amiodarone-induced pulmonary toxicity (APT) is a serious adverse event that can lead to death. The aims of our study are to determine factors associated with mortality and to describe outcome and sequelae of patients with APT.
  
  
  METHODS
  Forty-six patients with APT were divided into two groups according to survival at day 90 for a clinical, functional, biological and radiological comparaison. We then evaluated the evolution of 15 survivors at a median of three months [1-6 months] and/or 12 months [8-36 months].
  
  
  RESULTS
  Mortality of APT at day 90 was 37% (17 patients) and was linked to the speed of onset of symptoms and a high HRCT alveolar score. Angiotensin system antagonist treatment was prescribed significantly more in the survival group (p = 0.042, HR 0.34 (95% CI 0.12-0.96)). In surviving patients, dyspnea, vital capacity and HRCT alveolar score improved significantly while HRCT fibrosis score deteriorated gradually during the first six months. At the end of the study, all the surviving patients presented functional and/or radiological sequelae.
  
  
  CONCLUSIONS
  Severity of APT is linked to the extent and speed of onset of pulmonary damage. After the initial episode, the patients who survived improved slowly but with persistent sequelae.
authors.affiliation: CHRU Tours, Service de Pneumologie, Tours, France.
authors.forename: J
authors.initials: J
authors.lastname: Mankikian
authors.affiliation: CHRU Tours, Service de Radiologie, Tours, France.
authors.forename: O
authors.initials: O
authors.lastname: Favelle
authors.affiliation: Université François Rabelais, UMR 1100, F-37032 Tours, France; INSERM, Centre d'Etude des Pathologies Respiratoires, UMR 1100/EA6305, F-37032 Tours, France; CHRU Tours, Service de Réanimation Médicale, Tours, France.
authors.forename: A
authors.initials: A
authors.lastname: Guillon
authors.affiliation: CHRU Tours, Service de Pneumologie, Tours, France; Université François Rabelais, UMR 1100, F-37032 Tours, France; INSERM, Centre d'Etude des Pathologies Respiratoires, UMR 1100/EA6305, F-37032 Tours, France.
authors.forename: L
authors.initials: L
authors.lastname: Guilleminault
authors.affiliation: CHRU Tours, Service d'anatomopathologie, Tours, France.
authors.forename: B
authors.initials: B
authors.lastname: Cormier
authors.affiliation: CHRU Tours, Service de Pharmacologie Clinique Centre Régional de Pharmacovigilance, Tours, France.
authors.forename: A P
authors.initials: AP
authors.lastname: Jonville-Béra
authors.affiliation: Université François Rabelais, UMR 1100, F-37032 Tours, France; CHRU Tours, Service de Réanimation Médicale, Tours, France.
authors.forename: D
authors.initials: D
authors.lastname: Perrotin
authors.affiliation: CHRU Tours, Service de Pneumologie, Tours, France; Université François Rabelais, UMR 1100, F-37032 Tours, France; INSERM, Centre d'Etude des Pathologies Respiratoires, UMR 1100/EA6305, F-37032 Tours, France.
authors.forename: P
authors.initials: P
authors.lastname: Diot
authors.affiliation: CHRU Tours, Service de Pneumologie, Tours, France; Université François Rabelais, UMR 1100, F-37032 Tours, France; INSERM, Centre d'Etude des Pathologies Respiratoires, UMR 1100/EA6305, F-37032 Tours, France. Electronic address: karoun@orange.fr.
authors.forename: S
authors.initials: S
authors.lastname: Marchand-Adam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008171:Lung Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000889:Anti-Arrhythmia Agents; D005938:Glucocorticoids; D000638:Amiodarone
keywords: Amiodarone; Amiodarone-induced pulmonary toxicity; Drug toxicity; High resolution computer tomography; Pulmonary function tests