Iodine Determination in Amiodarone Lung

Abstract

To the Editor:Amiodarone is an iodine derivate, and its accumulation in the pulmonary parenchyma has been documented.1Heger J.J. Prystowsky E.N. Zipes D. Relationships between amiodarone dosage, drug concentrations, and adverse side effects.Am Heart J. 1983; 106: 931-935Abstract Full Text PDF PubMed Scopus (104) Google Scholar Iodine has also been found in the alveolar macrophages.2Brambilla C. Chavez L. Piot M. Rigaud D. Paramelle B. Pneumopathie a l'amiodarone.La Presse Médicale. 1983; 12: 1236Google ScholarWe present a case where iodine quantification in the pulmonary tissue was carried out, with lung biopsy thoracotomy (LBT). A 69-year-old man had an amiodarone intake during 15 months of 200 mg/day. He developed symptoms of progressive respiratory insufficiency that required ICU treatment. Chest radiology displayed diffuse bilateral alveolar-interstitial pattern. Most common causes of diffuse pulmonary infiltrates were discarded through data obtained with Swan-Ganz catheterization, bronchofiberscopy, bacteriologic study with Barlett aspiration catheter, BAL cell count, virologic and serologic studies (Table 1). Pulmonary scanning with Ga 67 showed mild diffuse hypercaptation in posterior lower segments of left lung. Biopsic sample was carried out in this area (LBT). Our pathologic findings correlated with data reported by Marchilinsky.3Marchilinski F.E. Gansler T.S. Waxman H.L. Josephson M.E. Amiodarone pulmonary toxicity.Ann Intern Med. 1982; 50: 1066-1074Google Scholar Mineralogic quantification with spectrophotometry was performed.4Marceenko Z. Spectrophotometric determination of elements. Ellis Hawood, New York1976: 296-298Google Scholar Iodine concentration found was 2.1×10.6 This determination proved to be negative in a necropsic analysis carried out in a patient without respiratory disease and no history of amiodarone intake, and of same age as the reported case.Table 1Hemodynamic DataBefore equalizationAfter equalizationCO2.8 L/min4.1 L/minWP19 mm Hg13 mm HgCVP24 cm H2O16 cm H2OBP80/50 mm Hg130/70 mm HgPVR450 dynosecocm5400 dynosecocm5SVR2200 dynosecocm5960 dynosecocm5CO = cardiac output; WP = wedge pressure; CVP = central venous pressure; PVR = pulmonary vascular resistance; SVR = systemic vascular resistance Open table in a new tab We conclude that spectrometric determination is useful in evaluating iodine levels in lung tissue. Amiodarone-treated patients display iodine-recognizable levels in lung tissue samples. To the Editor: Amiodarone is an iodine derivate, and its accumulation in the pulmonary parenchyma has been documented.1Heger J.J. Prystowsky E.N. Zipes D. Relationships between amiodarone dosage, drug concentrations, and adverse side effects.Am Heart J. 1983; 106: 931-935Abstract Full Text PDF PubMed Scopus (104) Google Scholar Iodine has also been found in the alveolar macrophages.2Brambilla C. Chavez L. Piot M. Rigaud D. Paramelle B. Pneumopathie a l'amiodarone.La Presse Médicale. 1983; 12: 1236Google Scholar We present a case where iodine quantification in the pulmonary tissue was carried out, with lung biopsy thoracotomy (LBT). A 69-year-old man had an amiodarone intake during 15 months of 200 mg/day. He developed symptoms of progressive respiratory insufficiency that required ICU treatment. Chest radiology displayed diffuse bilateral alveolar-interstitial pattern. Most common causes of diffuse pulmonary infiltrates were discarded through data obtained with Swan-Ganz catheterization, bronchofiberscopy, bacteriologic study with Barlett aspiration catheter, BAL cell count, virologic and serologic studies (Table 1). Pulmonary scanning with Ga 67 showed mild diffuse hypercaptation in posterior lower segments of left lung. Biopsic sample was carried out in this area (LBT). Our pathologic findings correlated with data reported by Marchilinsky.3Marchilinski F.E. Gansler T.S. Waxman H.L. Josephson M.E. Amiodarone pulmonary toxicity.Ann Intern Med. 1982; 50: 1066-1074Google Scholar Mineralogic quantification with spectrophotometry was performed.4Marceenko Z. Spectrophotometric determination of elements. Ellis Hawood, New York1976: 296-298Google Scholar Iodine concentration found was 2.1×10.6 This determination proved to be negative in a necropsic analysis carried out in a patient without respiratory disease and no history of amiodarone intake, and of same age as the reported case. CO = cardiac output; WP = wedge pressure; CVP = central venous pressure; PVR = pulmonary vascular resistance; SVR = systemic vascular resistance We conclude that spectrometric determination is useful in evaluating iodine levels in lung tissue. Amiodarone-treated patients display iodine-recognizable levels in lung tissue samples.