Amiodarone-induced pulmonary toxicity: Case study with syndrome analysis

Cott, Theodore E. Van; Yehle, Karen S.; DeCrane, Susan K.; Thorlton, Janet

doi:10.1016/j.hrtlng.2013.05.004

Cited by 21 publications

(19 citation statements)

References 41 publications

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“…There is also speculation that amiodarone may induce a multifactorial pulmonary toxicity. Mechanisms suggested for this process include a dysregulation of lysosomal enzymes, a maladaptive immune response of Th1 and Th2 cells, and proapoptotic effects on alveolar epithelial cells . This pulmonary deterioration may result in right heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…Mechanisms suggested for this process include a dysregulation of lysosomal enzymes, a maladaptive immune response of Th1 and Th2 cells, and proapoptotic effects on alveolar epithelial cells. 20 This pulmonary deterioration may result in right heart failure. Finally, amiodarone possesses an unusually long and variable half-life, which can range from 21 to 120 days [5][6][7][8][9]21,22 It is extremely difficult, therefore, to gauge its compounded pharmacologic effects when used chronically.…”

Section: Discussionmentioning

confidence: 99%

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Discontinuing amiodarone treatment prior to heart transplantation lowers incidence of severe primary graft dysfunction

Hoemann

Takayama

Jennings

et al. 2020

Clinical Transplantation

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Background Recent studies have shown an increased incidence of primary graft dysfunction (PGD) in patients treated with amiodarone prior to orthotopic heart transplant (OHT). We hypothesized that discontinuation of amiodarone before OHT may lower the incidence of severe PGD. Methods This was a single‐center retrospective study of 381 adult OHT recipients between January 2010 and June 2017. Within 6 months prior to OHT, 197 did not receive amiodarone (Group 1), 142 continued amiodarone to OHT (Group 2), and 42 had amiodarone treatment discontinued before OHT (Group 3). Results 53 (13.9%) participants developed severe PGD, 13 (6.6%) of which were in Group 1, 36 (25.4%) were in Group 2, and 4 (9.5%) were in Group 3 (P < .001). Multivariable analysis revealed continued amiodarone treatment to OHT (Group 2; OR, 3.70; 95% CI, 1.26‐10.88; P = .018) to be an independent risk factor for the development of severe PGD when Group 1 served as the reference group. Moreover, patients in Group 3 had no difference in the risk of severe PGD (OR = 0.416, 95% CI = 0.08‐2.15; P = .296). Conclusion We found that discontinuing amiodarone treatment prior to OHT resulted a lower incidence of severe PGD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Discontinuing amiodarone treatment prior to heart transplantation lowers incidence of severe primary graft dysfunction

Hoemann

Takayama

Jennings

et al. 2020

Clinical Transplantation

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“…Among cardiovascular agents, amiodarone-widely used for the treatment of arrhythmias-is the drug that is most frequently associated with changes in respiratory function; an incidence ranging between 4% and 6% has been reported [41,42], with a mortality rate up to 20% [11]. Three different pathogenetic mechanisms have been reported: The first one is related to the nature of amphiphilic cationic that causes dysregulation of the activity of lysosomal enzymes, the second one to the activation of an aberrant immune response in a framework of lipoid pneumonia, and the third one to the induction of angiotensinogen expression.…”

Section: Cardiovascular Drugsmentioning

confidence: 99%

HRCT Patterns of Drug-Induced Interstitial Lung Diseases: A Review

et al. 2020

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Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, which may be related to different causes. A low percentage of these lung diseases may be secondary to the administration of drugs or substances. Through the PubMed database, an extensive search was performed in the fields of drug toxicity and interstitial lung disease. We have evaluated the different classes of drugs associated with pulmonary toxicity. Several different high resolution computed tomography (HRCT) patterns related to pulmonary drug toxicity have been reported in literature, and the most frequent ILDs patterns reported include Nonspecific Interstitial Pneumonia (NSIP), Usual Interstitial Pneumonia (UIP), Hypersensitivity Pneumonitis (HP), Organizing Pneumonia (OP), Acute Respiratory Distress Syndrome (ARDS), and Diffuse Alveolar Damage (DAD). Finally, from the electronic database of our Institute we have selected and commented on some cases of drug-induced lung diseases related to the administration of common drugs. As the imaging patterns are rarely specific, an accurate evaluation of the clinical history is required and a multidisciplinary approach—involving pneumologists, cardiologists, radiologists, pathologists, and rheumatologists—is recommended.

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“…Lung injury may be secondary to occupational or environmental exposures (1), in addition to infection (2). Drug induced pathogenesis has to be taken into consideration and amiodarone, often prescribed for the control of atrial and ventricular arrhythmias is considered a potential cause (3). …”

Section: Introductionmentioning

confidence: 99%

Comparative Study between Intravenous and Intraperitoneal Stem Cell Therapy in Amiodarone Induced Lung Injury in Rat

Zickri¹,

Fadl²,

Gabr³

2014

Int J Stem Cells

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Background and Objectives:The fibrosing form of lung injury (occupational, environmental, infective or drug induced) is associated with significant morbidity and mortality. Amiodarone (AM), often prescribed for control of arrhythmias is considered a potential cause. No effective treatment was confirmed, except lung transplantation. Intravenous (IV) stem cell therapy may produce pulmonary emboli or infarctions. Despite being commonly used in clinical practice, the intraperitoneal (IP.) route has been rarely used for cell delivery. The present study aimed at investigating and comparing the possible effect of IP stem cell therapy (SCT) on pulmonary toxicity versus the intravenous route in a rat model of amiodarone induced lung damage.Methods and Results:36 adult male albino rats were divided into 4 groups. Rats of AM group were given 30 mg/kg daily orally for 4 weeks. Rats of IV SCT group were injected with stem cells in the tail vein. Rats of IP SCT group received IP cell therapy. Histological, histochemical, immunohistochemical and morphometric studies were performed. Obstructed bronchioles, overdistended alveoli, reduced type I pneumocytes, increased thickness of alveolar septa and vessels wall besides increased area% of collagen fibers regressed in response to IV and IP SCT. The improvement was more obvious in IV group. The area% of Prussion blue +ve and CD105 +ve cells was significantly higher in IV group.Conclusions:Cord blood MSC therapy proved definite amelioration of lung injury ending in fibrosis. The effect of IP SCT was slightly inferior to that of IV SCT, which may be overwhelmed by repeated IP injection.

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Amiodarone-induced pulmonary toxicity: Case study with syndrome analysis

Cited by 21 publications

References 41 publications

Discontinuing amiodarone treatment prior to heart transplantation lowers incidence of severe primary graft dysfunction

Discontinuing amiodarone treatment prior to heart transplantation lowers incidence of severe primary graft dysfunction

HRCT Patterns of Drug-Induced Interstitial Lung Diseases: A Review

Comparative Study between Intravenous and Intraperitoneal Stem Cell Therapy in Amiodarone Induced Lung Injury in Rat

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