Amiodarone
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Pleuroparenchymal fibroelastosis: case report A 68-year-old woman developed pleuroparenchymal fibroelastosis (PPFE) during treatment with amiodarone for atrial fibrillation. The woman was hospitalised due to recurrent episodes of a dry cough for the past 2 years, which significantly worsened in the last 6 months. High resolution computed tomography (HRCT) showed consolidations in both upper lobes in thoracic. She had been receiving amiodarone [dosage and route not stated] and warfarin for atrial fibrillation, which was diagnosed 5 years prior. Additionally, she was receiving nimodipine for arterial hypertension. Her lung function tests revealed normal lung volumes and diffusion capacity of carbon monoxide was found to be 79.3%. Her arterial blood gases values were also under normal range. Her chest radiograph revealed subpleural thickening at upperlobes, mainly in the right hemithorax. These findings were clearly observed under the chest HRCT scan, related to parenchymal reticulation and peripheral traction bronchiectasisat upper lobes, without lower lobes abnormalities. The histology of CT guided transthoracic biopsy in the left lung apex revealed fibrosis, with dense collagen andelastic fibres, suggestive of PPFE. Thus, based on her histology, clinical and imaging, she was diagnosed with PPFE secondary to amiodarone [outcome not stated]. The woman’s therapy with amiodarone was discontinued, while nimodipine and warfarin were maintained. Following withdrawal of amiodarone, a significant decrease in the frequency and intensity of cough episodes was noted. During 12 months of follow up, a clinical, functional and imaging stability was observed. Oliveira M, et al. Pleuroparenchymal Fibroelastosis as Another Potential Lung Toxicity Pattern Induced by Amiodarone. Archivos de Bronconeumologia 56: 55-56, No. 1, Jan 803449604 2020. Available from: URL: http://doi.org/10.1016/j.arbres.2019.06.011
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Reactions 25 Jan 2020 No. 1788
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