article · 01/01/2013
In vivo probe-based confocal laser endomicroscopy in amiodarone-related pneumonia
Résumé
Probe-based confocal laser endomicroscopy (pCLE) allows microscopic imaging of the alveoli during bronchoscopy. The objective of the study was to assess the diagnostic accuracy of pCLE for amiodarone-related pneumonia (AMR-IP). Alveolar pCLE was performed in 36 nonsmoking patients, including 33 consecutive patients with acute or subacute interstitial lung disease (ILD), of which 17 were undergoing treatment with amiodarone, and three were amiodarone-treated patients without ILD. Nine out of 17 patients were diagnosed with high-probability AMR-IP (HP-AMR-IP) by four experts, and three separate observers. Bronchoalveolar lavage findings did not differ between HP-AMR-IP and low-probability AMR-IP (LP-AMR-IP) patients. In HP-AMR-IP patients, pCLE showed large (>20 mu m) and strongly fluorescent cells in 32 out of 38 alveolar areas. In contrast, these cells were observed in only two out of 39 areas from LP-AMR-IP patients, in one out of 59 areas from ILD patients not receiving amiodarone and in none of the 10 areas from amiodarone-treated patients without ILD (p<0.001; HP-AMR-IP versus other groups). The presence of at least one alveolar area with large and fluorescent cells had a sensitivity, specificity, negative predictive value and positive predictive value for the diagnosis of AMR-IP of 100\%, 88\%, 100\% and 90\%, respectively. In conclusion, pCLE appears to be a valuable tool for the in vivo diagnosis of AMR-IP in subacute ILD patients.
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Salauen, M., Roussel, F., Bourg-Heckly, G., Vever-Bizet, C., Dominique, S., Genevois, A., Jounieaux, V., Zalcman, G., Bergot, E., Vergnon, J.-M., & Thiberville, L. (2013). In vivo probe-based confocal laser endomicroscopy in amiodarone-related pneumonia. https://doi.org/10.1183/09031936.00191911@article{Salauen2013_81,
author = {Salauen, Mathieu and Roussel, Francis and Bourg-Heckly, Genevieve and Vever-Bizet, Christine and Dominique, Stephane and Genevois, Anne and Jounieaux, Vincent and Zalcman, Gerard and Bergot, Emmanuel and Vergnon, Jean-Michel and Thiberville, Luc},
year = {2013},
month = {1},
title = {In vivo probe-based confocal laser endomicroscopy in amiodarone-related pneumonia},
volume = {42},
number = {6},
abstract = {Probe-based confocal laser endomicroscopy (pCLE) allows microscopic imaging of the alveoli during bronchoscopy. The objective of the study was to assess the diagnostic accuracy of pCLE for amiodarone-related pneumonia (AMR-IP). Alveolar pCLE was performed in 36 nonsmoking patients, including 33 consecutive patients with acute or subacute interstitial lung disease (ILD), of which 17 were undergoing treatment with amiodarone, and three were amiodarone-treated patients without ILD. Nine out of 17 patients were diagnosed with high-probability AMR-IP (HP-AMR-IP) by four experts, and three separate observers. Bronchoalveolar lavage findings did not differ between HP-AMR-IP and low-probability AMR-IP (LP-AMR-IP) patients. In HP-AMR-IP patients, pCLE showed large (>20 mu m) and strongly fluorescent cells in 32 out of 38 alveolar areas. In contrast, these cells were observed in only two out of 39 areas from LP-AMR-IP patients, in one out of 59 areas from ILD patients not receiving amiodarone and in none of the 10 areas from amiodarone-treated patients without ILD (p<0.001; HP-AMR-IP versus other groups). The presence of at least one alveolar area with large and fluorescent cells had a sensitivity, specificity, negative predictive value and positive predictive value for the diagnosis of AMR-IP of 100\textbackslash{}\%, 88\textbackslash{}\%, 100\textbackslash{}\% and 90\textbackslash{}\%, respectively. In conclusion, pCLE appears to be a valuable tool for the in vivo diagnosis of AMR-IP in subacute ILD patients.},
url = {http://www.dx.doi.org/10.1183/09031936.00191911},
doi = {10.1183/09031936.00191911},
issn = {0903-1936},
}TY - JOUR
AU - Salauen, Mathieu
AU - Roussel, Francis
AU - Bourg-Heckly, Genevieve
AU - Vever-Bizet, Christine
AU - Dominique, Stephane
AU - Genevois, Anne
AU - Jounieaux, Vincent
AU - Zalcman, Gerard
AU - Bergot, Emmanuel
AU - Vergnon, Jean-Michel
AU - Thiberville, Luc
PY - 2013
DA - 2013/01/01
TI - In vivo probe-based confocal laser endomicroscopy in amiodarone-related pneumonia
VL - 42
IS - 6
SN - 0903-1936
AB - Probe-based confocal laser endomicroscopy (pCLE) allows microscopic imaging of the alveoli during bronchoscopy. The objective of the study was to assess the diagnostic accuracy of pCLE for amiodarone-related pneumonia (AMR-IP). Alveolar pCLE was performed in 36 nonsmoking patients, including 33 consecutive patients with acute or subacute interstitial lung disease (ILD), of which 17 were undergoing treatment with amiodarone, and three were amiodarone-treated patients without ILD. Nine out of 17 patients were diagnosed with high-probability AMR-IP (HP-AMR-IP) by four experts, and three separate observers. Bronchoalveolar lavage findings did not differ between HP-AMR-IP and low-probability AMR-IP (LP-AMR-IP) patients. In HP-AMR-IP patients, pCLE showed large (>20 mu m) and strongly fluorescent cells in 32 out of 38 alveolar areas. In contrast, these cells were observed in only two out of 39 areas from LP-AMR-IP patients, in one out of 59 areas from ILD patients not receiving amiodarone and in none of the 10 areas from amiodarone-treated patients without ILD (p<0.001; HP-AMR-IP versus other groups). The presence of at least one alveolar area with large and fluorescent cells had a sensitivity, specificity, negative predictive value and positive predictive value for the diagnosis of AMR-IP of 100\%, 88\%, 100\% and 90\%, respectively. In conclusion, pCLE appears to be a valuable tool for the in vivo diagnosis of AMR-IP in subacute ILD patients.
DO - 10.1183/09031936.00191911
UR - http://www.dx.doi.org/10.1183/09031936.00191911
ER -