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Postgrad Med J 89:14-19 doi:10.1136/postgradmedj-2011-130209
  • Original article

Statin-induced lung injury: diagnostic clue and outcome

Open Access
  1. Shi-Chuan Chang1,4
  1. 1Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  2. 2Respiratory Care Unit, Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
  3. 3School of Medicine, National Yang-Ming University, Taipei, Taiwan
  4. 4Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan
  1. Correspondence to Dr Shi-Chuan Chang, Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, scchang{at}vghtpe.gov.tw
  • Received 14 March 2012
  • Revised 28 July 2012
  • Accepted 3 September 2012
  • Published Online First 5 October 2012

Abstract

Background Statin-induced lung injury (SILI) is an uncommon but serious complication of statins. The clinical features and outcome of patients with SILI vary widely. Clinical data relevant to diagnosis and outcome of patients with SILI were investigated in this study.

Method Four cases of SILI diagnosed at our institute and 12 cases reported in the English literature from 1995 to 2010 were studied. The patients were further divided into favourable and unfavourable outcome groups and compared.

Results Compared with the 12 previously reported cases, fever (p=0.008) and consolidation (p=0.027) were more common and duration of statin treatment was significantly shorter (p=0.030) in our patients. Foamy alveolar macrophages in bronchoalveolar lavage fluid (BALF) were found in our four patients. Patients with cough (p=0.024), fever (p=0.026) and alveolar infiltrates (p=0.036), especially ground-glass opacity (GGO) (p=0.001) shown on thoracic high-resolution CT (HRCT), had a favourable outcome. Conversely, those with fibrosis shown on HRCT (p=0.008) had an unfavourable outcome. Stepwise logistic regression analysis demonstrated that cough (p=0.011), fever (p=0.005), and alveolar infiltrates (p=0.017), GGO (p<0.001) and fibrosis (p=0.002) shown on thoracic HRCT were independent factors affecting the outcome of SILI.

Conclusions For patients with SILI, pulmonary phospholipidosis, as shown by foamy alveolar macrophages in BALF, may be valuable in diagnosis, and clinical symptoms and thoracic HRCT findings are of value in predicting the outcome.

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