Druginduced lung disease is a major source of iatrogenic injury. The exact frequency of dild is unknown, although is estimated that 2. Anticoagulants and their use in respiratory medicine. Adverse drug reactions are an important cause of morbidity and mortality, accounting for an estimated 5% of all hospitalizations and 0. Acute eosinophilic pneumonia aep is a rare idiopathic lung disease characterized by pulmonary eosinophilia. Interstitial lung disease ild, or diffuse parenchymal lung disease dpld, is a group of lung diseases affecting the interstitium the tissue and space around the alveoli air sacs of the lungs. A druginduced disease is the unintended effect of a drug, which results in mortality or morbidity with symptoms sufficient to prompt a patient to seek medical attention andor require hospitalization.
Druginduced pulmonary disease due to nonchemotherapeutic. Background statininduced lung injury sili is an uncommon but serious complication of statins. Druginduced pulmonary diseases can present in a variety of syndromes table 2, clinical pre sentations table 3, and radiographic patterns. This book is also rich in clear images, often illustrating short and very useful clinical cases to support the text. Druginduced interstitial lung disease diild is a serious side effect of chemotherapy in cancer patients with an extremely high mortality rate. Pdf pathology of lung disease ebook free download fbfa. Clinical data relevant to diagnosis and outcome of patients with sili were investigated in this study. The data presented demonstrate that a new nonsteroidal antiandrogen agent, bicalutamide, is capable of causing druginduced eosinophilic lung diseases. Whole genome sequencing to identify predictive markers for. However, clinicians are reluctant to place patients at further risk of illness, particularly in cases with severe druginduced diseases. A high index of suspicion and a thorough history of medication usage are critical to establishing the diagnosis of medicationinduced lung disease.
Eosinophilic lung disease induced by bicalutamide chest. This pathology of lung disease is edited by helmut popper. Druginduced respiratory disease in connective tissue. The possibility of druginduced lung disease should be considered in order to avoid potentially fatal consequences. As more patients with advanced prostate cancers receive antiandrogen chemotherapy, more cases of druginduced lung diseases may be encountered. The role of induced sputum in amiodaroneassociated interstitial lung diseases.
While the frequency of published data on more common ild entities such as the idiopathic interstitial pneumonias has increased in recent years, less attention has been given to relatively rarely occurring forms such as drug. Patients should be properly instructed to avoid inadvertent reexposure to the drug, or to structurally or pharmacologically related compounds. Druginduced lung injury respiratory disease series. Drugs have long been recognized as having the potential to cause pulmonary injury. A wide range of diseases are detailed from chemotherapy and radiation to biologicinduced lung disease, drug misuse, and special groups such as recipients of stem cell and solid organ transplants. Nitrofurantoininduced lung disease and prophylaxis of. The spectrum of druginduced interstitial lung disease. A 74yearold japanese man who received pazopanib for the treatment of femoral leiomyosarcoma and. Lung disease caused by amiodarone, a new antiarrythmic agent. Druginduced and iatrogenic respiratory disease is a book to study and to have on your desk to consult when facing doubt or when clinical suspicion arises. Druginduced interstitial lung disease diild is a very challenging topic both clinically and academically. Druginduced interstitial lung disease dild can be caused by chemotherapeutic agents, antibiotics, antiarrhythmic drugs, and immunosuppressive agents. There are two mechanisms involved in dild, which are probably interdependent.
Our case demonstrates a common radiographic finding, diagnostic workup, and histopathology to confirm our case for a vapinginduced lung disease, specifically exogenous lipoid pneumonia. Druginduced interstitial lung disease in the treatment of malignant lymphoma as a potential diagnostic marker. We report the findings in two patients with sulfasalazineinduced pulmonary disease. Pulmonary function tests pft are sometimes monitored during treatment with known pulmonary toxic drugs to detect asymptomatic drug induced interstitial lung disease dild. Download bookshelf software to your desktop so you can view your ebooks with or without internet access.
Druginduced interstitial lung disease diild occurs as a result of numerous agents, but the risk often only becomes apparent after the marketing authorisation of such agents. With the advent of new immunotherapy and evergrowing arsenal of. Case of druginduced interstitial lung disease secondary. Ct features of the usual interstitial pneumonia pattern. The first patient developed pulmonary interstitial fibrosis after more than 4 yr of treatment for crohns disease. Differentiating connective tissue diseaseassociated interstitial lung disease from idiopathic pulmonary fibrosis jonathan h. Radiotherapy and an increasing number of substances are implicated in the pathogenesis of interstitial lung disease ild. The site, available in both english and french, was created by the department of pulmonary diseases and intensive care unit in dijon, france and offers uptodate information about a growing number of druginduced lung diseases. Cytotoxic lung injury may result from direct injury to.
Pulmonary symptoms and chest roentgenographic and pulmonary function abnormalities gradually reversed after stopping the drug. Pathology of lung disease ebook pdf free download edited by helmut popper morphology. Ct figures 1 and 2 revealed bilateral patchy, ground glass airspace disease with honeycombing suggestive of amiodaroneinduced interstitial pneumonitis. The table below lists some drugs known to cause drug induced lung disease. It concerns alveolar epithelium, pulmonary capillary endothelium, basement membrane, and perivascular and perilymphatic tissues. In this study, to identify genetic variants with greater risk of diild, we carried out whole genome sequencing wgs of germline dna samples from 26 patients who developed diild, and conducted a casecontrol association study between these 26 cases. The diagnosis is based on a history of drug exposure, histologic evidence of lung damage, and. Twentyseven cases of druginduced interstitial lung. Twentyseven cases of druginduced interstitial lung disease associated with imatinib mesylate. Druginduced and iatrogenic respiratory disease pdf. In many cases of druginduced lung injury hrct is of limited value in. Pdf druginduced lung disease is a major source of iatrogenic. Unilateral antibioticinduced acute eosinophilic pneumonia.
This first edition wellillustrated textbook covers the full range of lung and pleural diseases from the pathologic standpoint. Interstitial lung disease induced by pazopanib treatment. Method four cases of sili diagnosed at our institute and 12 cases reported in the english literature from 1995 to 2010 were. Pdf drug induced interstitial lung disease researchgate. The precise incidence of druginduced lung disease is difficult to ascertain, because the signs and symptoms of disease are shared by many other pulmonary conditions and diseases. Drug induced pulmonary diseases by vishwanath gouda 1st year m.
Pulmonary function testing for the early detection of drug. Introduction currently there are no general guidelines for diagnosis or management of suspected druginduced di interstitial lung disease ild. The clinical features and outcome of patients with sili vary widely. Many patients are initially misdiagnosed and, therefore, continue using thccontaining vape pens. The objective was to survey a sample of current european practice in the diagnosis and management of diild, in the context of the prescribing information approved by regulatory authorities for 28 licenced drugs with a recognised risk of diild.
It may occur when an injury to the lungs triggers an abnormal healing. The precise incidence of druginduced lung disease is difficult to ascertain, because the signs and symptoms of. How consistently do physicians diagnose and manage drug. Drug induced interstitial lung disease pubmed central pmc. Amiodaroneinduced interstitial pneumonitis bmj case reports. Druginduced and iatrogenic respiratory disease european. Recognition of druginduced lung disease is difficult because the clinical, radiologic, and histologic findings are nonspecific 1, 2. In our patient, pulmonary toxicity can be due to mesalamine, infliximab, or a combination of both. Acute nitrofurantoininduced lung disease nild nild was first reported by fisk in 1957 who described an acute reaction. Ct findings of highattenuation parenchymalpleural abnormalities are thought to be related to the iodinated chemistry of the drug and its prolonged halflife within the lung. These unique properties of the drug and the use of ct to discriminate attenuation levels provide a means of identifying patients with significant pulmonary accumulation. The incidence is increasing with approximately 400 drugs known to potentially cause dild.
Causative agents dild can be caused by several therapeutic agents, including. Drug induced pulmonary diseases linkedin slideshare. The connection with drug use and the development of related inflammatory damage or idiosyncratic toxicities is hard to recognize and objectify, especially in those cases using multiple drugs. Druginduced interstitial lung disease dild is not uncommon and has many clinical patterns, ranging from benign infiltrates to lifethreatening acute respiratory distress syndrome. Druginduced interstitial lung disease dild can be caused by chemotherapeutic agents. Drug induced pulmonary disease is defined as any lung disease caused by a drug or medication 3. Drug induced interstitial lung disease diild occurs as a result of numerous agents, but the risk often only becomes apparent after the marketing authorisation of such agents. Recognition of druginduced lung disease, however, is difficult because the clinical, radiological, and histological findings are nonspecific. Drug induced interstitial lung disease bentham open.
Drug induced lung disease may affect the airways, the lung parenchyma, the pulmonary circulation, the pleura, the thoracic lymph nodes and the neuromuscular system. A range of world class contributions from key opinion leaders. Druginduced and iatrogenic respiratory disease pdf free download. Therefore, not every type of interstitial lung disease ild could be ruled out, and our differential for our patient accordingly included lung damage due to occupational or environmental agents, other druginduced pulmonary toxicities, radiationinduced lung injury, and idiopathic causes. The diagnosis is based on a history of drug exposure, histologic evidence of lung damage, and exclusion of other causes of lung injury. With the advent of new immunotherapy and evergrowing arsenal of chemotherapeutic and biologic agents for a variety of conditions, it is paramount for the clinician to assess for the development of pulmonary toxicity before irreversible lung damage occurs. Many drugs have been associated with pulmonary complications of various types, including interstitial inflammation and fibrosis, bronchospasm, pulmonary edema, and pleural effusions. This is the first case of interstitial lung disease as a druginduced toxicity in a uc patient on both mesalamine and infliximab. Bal cultures for bacteria, acidfast bacillus and fungus were also negative.
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