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Vol. 12. Issue 6.
Pages 725-730 (November - December 2006)
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Vol. 12. Issue 6.
Pages 725-730 (November - December 2006)
Caso Clínico\Clinical Case
Open Access
Fibrose pulmonar secundária à amiodarona – A propósito de um caso clínico
Amiodarone induced pulmonary fibrosis – A clinical case report
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Marta N. Silva1,*, Patrícia Bacellar1, Helena Martins1, Nélia Tinoco2, Francisco Costa3
1 Interna Complementar de Medicina Interna, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão
2 Assistente Hospitalar de Pneumologia, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão
3 Director do Serviço de Pneumologia, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão
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Resumo

A amiodarona é um eficaz fármaco anti-arrítmico usado para tratar arritmias ventriculares e supra-ventriculares, mas não isento de reacções adversas. A toxicidade pulmonar é uma delas, relativamente rara (5 a 10% dos casos), e pode ser fatal. Há vários factores que aumentam a susceptibilidadade para esta toxicidade, tais como a idade avançada e a doença pulmonar preexistente.

Apresentamos um caso clínico de toxicidade pulmonar induzida pela amiodarona (fibrose pulmonar) num doente do sexo masculino, de 81 anos. Estava medicado com este fármaco, desde há 5 anos, com uma dose diária de 200 mg.

Após a suspensão do fármaco e tratamento com corticosteróides sistémicos, houve melhoria clínica, funcional e radiológica.

Este caso clínico realça a necessidade de uma monitorização e diagnóstico precoce dos efeitos adversos do tratamento com a amiodarona e a dificuldade no seu diagnóstico, devido à inespecificidade dos sintomas, das manifestações clínicas e dos resultados dos exames complementares de diagnóstico.

Rev Port Pneumol 2006; XII (6): 725-730

Palavras-chave:
Fibrose pulmonar
toxicidade da amiodarona
Abstract

Amiodarone is an antiarrhytmic drug and it is used to treat supraventricular or ventricular rhythm disturbances. Nevertheless it is not free of side effects. Amiodarone-induced pulmonary toxicity is one of them and is relatively rare (5 to 10% of cases) and can be fatal. There are several cumulative factors that may enhance susceptibility to pulmonary toxicity, such as advanced age and pre-existing pulmonary dysfunction.

We present a case study of amiodarone-induced toxicity (pulmonary fibrosis) in an 81-year-old man. The patient had been treated with amiodarone for five years in daily dose 200 mg/day.

After withdrawing the drug and systemic corticoste-roid therapy, clinical, functional and radiological improvement was observed.

This case confirms the needs of a vigilant monitoring and early diagnosis of the adverse effects of amiodarone therapy, and the difficulty of diagnosing it due to the nonspecificity of symptoms, clinical findings, and test results.

Rev Port Pneumol 2006; XII (6): 725-730

Key-words:
Pulmonary fibrosis
amiodarone toxicity
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Copyright © 2006. Sociedade Portuguesa de Pneumologia/SPP
Pulmonology
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