1.Marked Recovery From Paraquat-Induced Lung Injury During Long-Term Follow-up.
Kwon Hyun LEE ; Hyo Wook GIL ; Young Tong KIM ; Jong Oh YANG ; Eun Young LEE ; Sae Yong HONG
The Korean Journal of Internal Medicine 2009;24(2):95-100
BACKGROUND/AIMS: Paraquat-induced lung injury has been considered a progressive and irreversible disease. The purpose of this study was to report the long-term evolution of lung lesions in eight survivors with significant paraquat-induced lung injuries who could be followed-up for longer than 6 months. METHODS: We retrospectively examined high-resolution computed tomography and pulmonary function test of eight survivors with significant paraquat-induced lung injurys. RESULTS: High-resolution computed tomography revealed a predominant pattern of irregularly shaped consolidation with traction bronchiectasis at 1-2 months after paraquat poisoning, a mixed pattern of irregularly shaped consolidation and ground-glass opacity at 3-12 months, and a mixed pattern of consolidation, groundglass opacity, and honeycombing at 1-2 years. At 3-12 months after paraquat ingestion, the areas of consolidation had markedly decreased and the decreased lung volume had returned to normal. At 1-2 years after paraquat poisoning, the cystic changes had disappeared. At 2-3 years after paraquat poisoning, the decrease in forced vital capacity had greatly improved to the normal range. CONCLUSIONS: Recovery of nearly normal pulmonary structure and function may occur over several years following paraquat poisoning. Pulmonary function (both forced vital capacity and forced expiratory volume in 1 sec) evolved toward normal in the long-term survivors of paraquat poisoning with initial prominent lung injuries.
Adolescent
;
Adult
;
Aged
;
Bronchiectasis/chemically induced
;
Female
;
Follow-Up Studies
;
Forced Expiratory Volume
;
Herbicides/*toxicity
;
Humans
;
Lung/*drug effects/physiopathology/radiography
;
Lung Injury/*chemically induced/physiopathology/radiography/therapy
;
Lung Volume Measurements
;
Male
;
Middle Aged
;
Paraquat/*toxicity
;
Pulmonary Fibrosis/chemically induced
;
Recovery of Function
;
Retrospective Studies
;
*Survivors
;
Time Factors
;
Tomography, X-Ray Computed
;
Vital Capacity
;
Young Adult
2.Clinical Outcome of Paraquat Poisoning.
The Korean Journal of Internal Medicine 2009;24(2):93-94
No abstract available.
Bronchiectasis/chemically induced
;
Forced Expiratory Volume
;
Herbicides/*toxicity
;
Humans
;
Lung/*drug effects/physiopathology/radiography
;
Lung Injury/*chemically induced/physiopathology/radiography/therapy
;
Lung Volume Measurements
;
Paraquat/*toxicity
;
Pulmonary Fibrosis/chemically induced
;
Recovery of Function
;
*Survivors
;
Time Factors
;
Tomography, X-Ray Computed
;
Vital Capacity
3.The diagnostic utility of chest computed tomography scoring for the assessment of amiodarone-induced pulmonary toxicity.
In Sook KANG ; Kyung Jin KIM ; Yookyung KIM ; Seong Hoon PARK
The Korean Journal of Internal Medicine 2014;29(6):746-753
BACKGROUND/AIMS: Amiodarone is one of the most widely used antiarrhythmic agents; however, amiodarone-induced pulmonary toxicity (APT) can be irreversible and sometimes fatal. The aim of this study was to evaluate the feasibility of chest computed tomography (CT) as a diagnostic tool for APT and to assess the utility of the CT APT score as an index for predicting the severity of APT. METHODS: Patients underwent amiodarone treatment for various reasons, most often atrial fibrillation, for more than 2 years, and those that received a cumulative dose > 100 g were enrolled. A total of 34 patients who underwent chest CT between December 2011 and June 2012 were enrolled, whether or not they had clinical symptoms. The APT CT score was defined as the number of involved regions in the lung, which was divided into 18 regions (right and left, upper, middle, and lower, and central, middle, and peripheral). The CT findings were evaluated according to the total dose and duration of amiodarone treatment and the results of a pulmonary function test. Clinical symptoms and outcomes were also evaluated according to APT CT scores. RESULTS: Seven patients had positive APT CT scores (interstitial fibrosis in five, organizing pneumonia in one, and mixed interstitial fibrosis and organizing pneumonia in one), and these patients exhibited significantly lower diffusion capacity for carbon monoxide in the lungs compared with patients without an increased APT CT score (70.2% +/- 6.9% vs. 89.7% +/- 19.4%; p = 0.011). Three of the seven patients experienced overt APT that required hospital admission. CONCLUSIONS: Chest CT is a useful diagnostic tool for APT, and the APT CT score might be a useful index for assessing the severity of APT.
Aged
;
Amiodarone/*adverse effects
;
Anti-Arrhythmia Agents/*adverse effects
;
Atrial Fibrillation/diagnosis/*drug therapy
;
Cross-Sectional Studies
;
Cryptogenic Organizing Pneumonia/chemically induced/physiopathology/*radiography/therapy
;
Feasibility Studies
;
Female
;
Forced Expiratory Volume
;
Hospitalization
;
Humans
;
Lung/drug effects/physiopathology/*radiography
;
Male
;
Middle Aged
;
Predictive Value of Tests
;
Prospective Studies
;
Pulmonary Diffusing Capacity
;
Pulmonary Fibrosis/chemically induced/physiopathology/*radiography/therapy
;
Respiratory Function Tests
;
Risk Factors
;
Time Factors
;
*Tomography, X-Ray Computed
;
Vital Capacity