[Value of lamellar body quantification in leukocytes in amiodarone toxicity]

Amiodarone is an amphiphilic drug that penetrates easily through the plasmatic membrane and can induce the production of lysosome lamellar bodies in virtually all cells of the organism, independently of toxic effects. This study determines the value of searching for lamellar bodies in peripheric leucocytes as a method of prevention of pulmonary toxic effects in long term amiodarone treated patients. The rate of leucocytes with lamellar bodies was determined in three groups of patients. The group I was composed of 8 patients with amiodarone induced pneumonia who were taking the drug for an average of 16.88 months (average of 386.60 mg a day). The group II was composed of 19 patients not presenting any toxic effects, and who were taking amiodarone for an average of 38.32 months (average of 260.62 mg a day). The group III consisted by 8 healthy volunteers. The leucocyte layer was sampled from centrifuged peripheric blood and examined by transmission electron microscopy. The average percentage of leucocytes with lamellar bodies was 1.82 in group I, 1.65 in group II and 3.47 in group III. The lamellar inclusions were seen in all groups. There were no significant qualitative or quantitative differences between the groups. The inclusions couldn't be differentiated from other previously described non amiodarone lamellar bodies, such as artifacts and those produced by cellular degeneration. Although lamellar bodies can be observed in leucocytes of patients taking amiodarone, the determination of the rate of affected leucocytes is of no help for predicting amiodarone pulmonary toxicity.