The Drug-Induced Respiratory Disease Website
Cardiac arrhythmia(s)/dysrhythmia(s) (AF, VT, VF, TdP) - QTc prolongation)
Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)
43Atrial fibrillation
2Ventricular tachycardia
2Ventricular fibrillation
1Bradycardia
16Tachycardia
5QTc prolongation
10Wandering pacemaker
1Torsades de pointe
4Asystole
6Sinus arrest
1Cardiac- cardiorespiratory/pulmonary arrest
28Sudden cardiac death
3Respiratory arrest - Apnea
7Hyperkinetic circulation
0Oropharyngeal erosion/bleeding
1Bradyarrhythmia
0Myocardial dysfunction - Heart failure
Left ventricular dysfunction/failure
29Right ventricular dysfunction/failure
1Heart failure (biventricular, congestive)
10Cardiovascular collapse - Cardiogenic shock - Hypotension
25Acute respiratory or cardiopulmonary failure
13Myocardial stunning
2Heart failure (thyrotoxicosis-, thyroid storm-mediated)
0Late left ventricular dysfunction/failure
1Myocardial ischemia - Coronary artery disease
Coronary artery disease (acute) - Myocardial ischemia/infarction
27Coronary artery disease (subacute, chronic)
1Coronary vasospasm - Vasospastic angina
10Eosinophilic coronary (peri)-arteritis
0Coronary artery dissection
2Calcification of the coronary arteries
0ST segment changes
2Heart block (bundle branch-, AV-block)
Myocarditis
Cardiomyopathy
Cardiotoxicity
Valvular heart disease
Endocardial involvement
Pulmonary edema
Pulmonary edema, cardiogenic
21Pulmonary edema, noncardiogenic (NCPE)
63Interstitial pulmonary edema
2Fluid retention
5Overload pulmonary edema (including posttransfusional (TACO))
3Capillary leak syndrome (CLS)
3Flash (fulminate) pulmonary edema
5Negative pressure pulmonary edema (NPPE)
4Pulmonary edema/ARDS of the ATRA syndrome
2The differentiation- or ATRA syndrome
1Transfusion-related acute lung injury (TRALI) (May cause ARDS)
4Reperfusion pulmonary edema
1Neurogenic pulmonary edema
1Pulmonary vasculopathies
Pulmonary arterial hypertension
35Acute pulmonary hypertension
4Rebound pulmonary arterial hypertension
1Pulmonary hypertension of the newborn (Persistent PHT)
1Pulmonary artery aneurysm(s)
3Worsening of preexisting PHTn
2Pulmonary vein stenosis
1Pulmonary vein thrombosis
0Pulmonary veno-occlusive disease
4Pulmonary infarction
1Pericardial involvement
Pericarditis
4Pericardial effusion (w/wo tamponade)
27Hemopericardium - Bloody pericardial effusion
10Effusive-constrictive pericarditis
0Constrictive pericarditis - Pericardial thickening
5Pericardial fibrosis
0Pleural/pericardial effusion, ANA positive (DI lupus)
13Postcardiac/-cardiotomy injury (PCIS-Dressler syndrome)
0Septic/purulent pericardial effusion
2Pericardial fat necrosis
0Pneumopericardium
4Pericardial calcification
0Pericardial-esophageal fistula
1Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative)
15Purulent pericardial effusion
1Lead poisoning
00
Chylous pericardial effusion (w/wo tamponade)
1Thrombosis - Embolism
Pulmonary embolism - Venous thrombosis/thrombo-embolism
30Pulmonary vascular microthrombi
1Cement embolism
2Intracardiac bone cement embolism
1Cyanoacrylate pulmonary embolism
1Fat/oil embolism - The FES embolism syndrome
6Lipiodol/contrast pulmonary embolism
0Mercury pulmonary embolism
1Crystal pulmonary embolism
1Foreign body/substance pulmonary embolism
2Foreign body pulmonary vasculopathy (Excipient lung disease)
5Air/gas embolism
0Right atrial thrombosis
0Right ventricular thrombus/thrombosis
1Systemic arterial thrombosis
3Left-sided intracavitary thrombosis
0Pleural involvement
Pleural effusion (uni or bilateral) (can accompany ILD induced by the drug)
36Massive pleural effusion
1Pleural effusion and coexisting ILD (both drug-induced)
1Eosinophilic pleural effusion
7Hemothorax - Serosanguineous pleural effusion
11Pneumothorax
9Empyema
1Pleural thickening - Fibrothorax
5Serositis - Polyserositis
2Black pleural effusion
1Esophageal pleural fistula
2Pneumothorax, bilateral
2Bilateral tension pneumothorax (can be fatal)
1Chylothorax
2Pleuroparenchymal fibroelastosis (PPFE)
2Pleuroparenchymal fibroelastosis (PPFE)
1Chest pain
Hemorrhage - Bleeding - Hematoma(s)
Hemomediastinum - Mediastinal hematoma
4Pulmonary hematoma
4Hematoma of/around central airway wall potentially causing UAO
13Retropharyngeal hematoma (may cause UAO)
1Alveolar hemorrhage (AH), diffuse AH (DAH)
63Alveolar hemorrhage, localized (e.g. lobar)
1Alveolar hemorrhage, diffuse (ANCA-positive/-related)
2Coagulopathy
7Hemoptysis
20Major/massive hemoptysis
5Vocal cord hematoma
1Thoracic epidural or spinal hematoma
3BAL: Gross or microscopic bleeding/hemorrhage
3Rectus abdominis sheath hematoma
1Epistaxis
4Submucosal airway petechiae/hemorrhage
1Airway hemorrhage visible on endoscopy
0Heart injury/trauma/perforation
Aortic involvement
Angioedema
Vasculitis
Mediastinal involvement/injury
Acute respiratory/cardiorespiratory failure
Respiratory distress or failure, not otherwise specified
5Acute lung injury - ARDS
90Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO
8Postoperative ARDS
1Respiratory failure from ventilatory depression (of neuromuscular cause or causes)
21Rigid chest syndrome - Chest wall rigidity - Stiff/wooden chest
3Respiratory acidosis - Hypercapnia - Elevated blood CO2
1Hypoxemia w/wo acute respiratory failure from hepatopulmonary syndrome
1Hemoglobinopathies (acquired, reversible)
Interstitial lung disease - Pulmonary infiltrates - Pulmonary fibrosis
Pneumonitis (ILD)
142Pneumonitis (ILD), acute and/or severe (may cause ARDS)
71Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)
62Acute eosinophilic pneumonia (AEP)
22Relapsing or migrating pneumonitis/pneumonia (see also Id)
4Diffuse alveolar damage (DAD) imaging pattern
8Amiodarone pulmonary toxicity - Amiodarone lung
2Pulmonary fibrosis (may improve but partly following drug discontinuation)
17Progression, acceleration or exacerbation of preexisting ILD/fibrosis
10Organizing pneumonia (OP/BOOP) pattern (an area or areas of consolidation on imaging)
30Pulmonary infiltrates
12Acute fibrinous organizing pneumonia (AFOP)
8Subclinical pulmonary infiltrates/ILD
6A mass or masses
1Rapidly progressive ILD/pulmonary fibrosis (Hamman-Rich syndrome)
5An area or areas of consolidation
3Delayed ILD, -pneumonitis, -fibrosis
2Lung nodule or nodules
3ILD with a granulomatous component
5Focal/localized area of pneumonitis/fibrosis
1Transient pulmonary opacities/infiltrates (TAPO)
1Radiation recall pneumonitis
2Aspiration, aspiration pneumonia (w/wo demonstrable pharyngeal dysmotility)
4Radiation-induced lung injury (RILI)
3Exogenous lipoid pneumonia (subacute, acute)
5Unilateral interstitial lung disease
1Lymphocytic interstitial pneumonia
1Chronic pneumonitis/ILD
3Shrinking lung syndrome
1Pulmonary alveolar proteinosis (PAP)
2Pneumoconiosis (silicosis, talcosis...)
1Hypersensitivity pneumonitis pattern
1Chemical (toxic) pneumonitis
5Transient pulmonary opacities/infiltrates (see also under Iav)
1The association of ILD and myositis
2Fatal pulmonary fibrosis
1Irreversible respiratory damage requiring lung transplantation
1Pulmonary function - Pulmonary physiology - PFTs
Neuromuscular dysfunction
Dyspnea, lone
Large airway involvement
Angioedema (may cause UAO, asphyxia and death)
42Epiglottitis
1Tracheal injury
1Vocal cord dysfunction, adduction, closure
4Recurrent laryngeal nerve palsy - Hoarseness
2Laryngospasm (a.k.a. laryngismus)
6Thermal (burns, frostbite), chemical or caustic injury (face, buccal mucosa, pharynx, upper airway)
5Airway pigmentation (black, bluish, petechial)
1Tongue involvement (edema, glossitis, hematoma)
9Trismus (lockjaw)
1Rhinosinusitis
1Sputum production - Bonchorrhea - ‘Bronchitis’
1Bronchiectasis
2Chemical laryngitis
0A ‘tracheobronchitis’ clinical pattern
1Nasal, palatal and/or pharyngeal pathology
1Central airway instability - Tracheomalacia
1Acute laryngeal dystonia
1Small airway involvement
Bronchospasm - Wheezing - Asthma
51Occupational asthma
2Severe or catastrophic bronchospasm or asthma attack (can be fatal)
17Cough (lone)
11Obliterative bronchiolitis (an imaging and/or pathological pattern consistent with)
4Deterioration/exacerbation of preexisting asthma or COPD
2Eosinophilic airway disease (asthma, bronchitis, bronchiolitis)
0Exacerbation or deterioration of preexisting asthma
2Exacerbation or deterioration of preexisting COPD
6Bronchospasm and angioedema
1Cough, acute (can be violent and/or explosive)
1Bronchiolitis (a clinical-imaging pattern suggestive of)
2Obstructive airway dysfunction (see also IVc, XVx)
1Reactive airway dysfunction syndrome (RADS)
2Airway hyperresponsiveness
1Imaging features
Imaging: A change in heart shape (viz. cardiomegaly)
0Imaging: A miliary pattern (diffuse random micronodules)
1Imaging: Upper/central airway narrowing
1Imaging: Textiloma - Gossypiboma
1Imaging: An area or areas of consolidation
3Imaging: Alveolar opacities or haze with a batwing or butterfly distribution
2Imaging: Pneumatocele or pneumatoceles
1Imaging: Avid pleural uptake on PET-scan
1Imaging: Cavitating/cavitary lung/pulmonary nodule or nodules
1Imaging: Bronchiectasis
1Imaging: Centrilobular micronodules (can be diffuse)
2Imaging: Ground-glass opacities / GGO shadowing
7Imaging: Foreign body pulmonary embolism
1Imaging: A 'tree-in-bud' pattern
2Imaging: Lung nodule or nodules
1Imaging: Asymmetrical, predominantly unilateral involvement
2Paraffinoma - Lipidoma (ELP in the form of a nodule or mass)
1Imaging: Waxing and waning nodules
2Imaging: A mosaic pattern of attenuation
1Imaging: Pulmonary vein stenosis
0Imaging: Reverse ventilation-perfusion mismatch
1Imaging: Reverse or photographic negative of the batwing pattern
1Imaging: Interlobular septal thickening
1Imaging: Pleural effusion
1Imaging: Metallic densities in trachea or large airways
1Imaging: Intrathoracic lymph node enlargement
1Lipid-laden mediastinal lymphadenopathy
1Imaging: Diffuse haze
1Eye catchers
Eye-catcher: Tongue edema
1Eye-catcher: Cement (pulmonary) embolism
2Eye catcher: Mercury embolism (pulmonary and/or in other tissues)
0Eye catcher: Gossypiboma - Textiloma
1Eye catcher: A batwing or butterfly pattern on chest imaging
2Eye-catcher: An electron-dense liver on unenhanced CT
1Eye-catcher: An electron-dense ('white') thyroid
1Midline destructive lesions
1Esophageal pathology
Esophageal hematoma (may cause chest pain and/or tracheal compression)
4Esophageal pathology (erosion, ulcer, tear, rupture, fistula, Boerhaave’s syndrome)
8Atrio-esophageal fistula
0Aortoesophageal fistula
0Esophageal toxicity
3Esophageal dysmotility
0Esophageal stenosis/stricture
1Dysphagia
0Pharmacobezoar
1Esophageal necrosis
1Histopathology (for pulmonary pathology see in ‘Pneumotox’ (a free companion App)
Path: Myocarditis
4Path: Lymphocytic myocarditis
1Path: Eosinophilic myocarditis
2Path: Giant cell myocarditis
0Path: Lysosomal storage cardiomyopathy/cardiotoxicity
1Path: Myocardial vasculitis
2Path: Necrotizing myocarditis
0Path: Myocardial fibrosis
1Path: Fibrinous pericarditis
0Path: Pulmonary edema
2Path: Alveolar hemorrhage
2Path: Pulmonary hypertension incl. angiomatoid vasculopathy
2Path: Pulmonary veno-occlusive disease (PVOD)
1Path: Foreign body embolism, microangiopathy, vasculopathy
2Path: Lipid/fat embolism
3Path: Silicone droplets/vacuoles in lung tissue, pulmonary vasculature, or lymph nodes
0Silicone pneumonitis - 'Silicone lung'
1Path: Silicone pleural nodules or siliconoma (See under Vw)
0Path: Striated heart muscle damage
0Path: Coronary artery vasculitis w/wo eosinophilia
0Path: Elemental (fluid, metallic) mercury embolism
0Path: Silicone pulmonary embolism
1Path: Acrylate bone cement pulmonary embolism
1Granulomatous mediastinal lymphadenopathy
2Path: Acute fibrinous organizing pneumonia (AFOP) pattern (see also If)
1Infections
Septic pulmonary embolism
2Respiratory tract infection incl. pneumonia
2Staphylococcal pneumonia/infection
0Lung abscess/abscesses (see also VIr)
0Tuberculosis (pulmonary, pleural, extrapulmonary or disseminated). Reactivation or de novo)
2Opportunistic pulmonary/systemic infections
2Pneumocystis jiroveci pneumonia
2Nontuberculous pulmonary mycobacterial infection/superinfection
1Cryptococcus pulmonary and/or systemic infection
1Viral pneumonia
1Disordered breathing during sleep
Autoimmune syndromes - Systemic reactions or conditions
Autoimmunity - An autoimmune condition (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs)
8Lupus - Lupus syndrome
22Sarcoid-like granulomatosis (endo-/extrathoracic)
7Subclinical ANA positivity
4Subclinical ANCA positivity
1Anaphylaxis - Anaphylactoid reaction (either of these can be fatal)
56Generalized myopathy/muscle weakness
2Myasthenia gravis - Myasthenic-like syndrome
4Guillain-Barré (or GB-like) syndrome (w/wo ARF)
3Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
4Multiple organ dysfunction/failure (MODS/MOF)
7Refractoriness to epineprine in case of anaphylaxis
1DRES syndrome - DRESS-like reaction - Drug hypersensitivity syndrome
15A flare of preexisting immune-mediated systemic/rheumatic disease
1Rhabdomyolysis
0Multisystem/systemic inflammatory response/syndrome
2Tumor lysis syndrome (TLS)
3Anti-GBM-related pneumorenal syndrome and DAH (Goodpasture) or flare of
1Dual MPO-/PR3-ANCA systemic disease/vasculitis or pseudovasculitis
2Pneumorenal syndrome (w/wo ANCAs)
2Pulmonary vasculitis or capillaritis
4Temporal arteritis (Horton’s)
2Anti-GBM antibody disease (Goodpasture-like or flare of preexisting GS)
1Anti Jo1 syndrome
1Cytokine release syndrome
1Protracted, prolonged anaphylaxis
2Granulomatosis with polyangiitis (typically +ANCA). Or flare of preexisting GPA
1Fatal anaphylaxis
1Antisynthetase antibodies (ASA) - ASA syndrome
2Polymyalgia rheumatica
1Polyarteritis nodosa-like condition
1Veterinary medicine and pathology
Veterinary: Cardiac arrhythmias
0Veterinary: Myocardial dysfunction
1Veterinary: Pulmonary edema
0Veterinary: Pulmonary hemorrhage (bleeding, hemoptysis, alveolar hemorrhage)
0Veterinary: (Peri-) tracheal/retropharyngeal hemorrhage
1Veterinary: Methemoglobinemia
1Veterinary: Pneumonitis - Interstitial lung disease
0Veterinary: Pulmonary fibrosis
0Veterinary: Acute Respiratory Distress Synndrome (ARDS)
0Veterinary: Anaphylaxis/Anaphylactoid reaction
0Veterinary: Respiratory/Ventilatory depression
0Veterinary: Flare of Myasthenia gravis
1Miscellaneous - Varia
Upper airway obstruction other than angioedema or hematoma
11Unilateral/Hemilingual (angio)edema
3Antiphospholipid antibodies w/wo the APL syndrome
6Death following exposure or poisoning
22Sniffing death - Death from inhalation of compound
5Cyanosis, a low SpO2 and normal measured PaO2
5Bluish, blue, pseudocyanotic skin discoloration
1Hypoxemia, low oxygen saturation (may occur in isolation)
6Cough syncope
2Fainting
0Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement)
18Calcification of tracheobronchial cartilaginous rings
1Metabolic acidosis (incl. lactic acidosis/-gap). May cause hyperpnea/dyspnea
8Hiccup
2Hemolytic anemia
1Finger clubbing
0Myopathy-Myositis-Polymyositis
6Hyperemesis
1CNS involvement/dysfunction/damage
1Venous thoracic outlet syndrome
1Hypocalcemia (may lead to respiratory muscle weakness and RF)
1Osteonecrosis of the jaw
1Foreign body (talc, constarch) retinopathy
1Pulmonary contusion
0Neutropenia, agranulocytosis (w/wo infection/sepsis)
1Hyperammoniemia (non-cirrhotic)
1Hypertension (systemic)
1Halitosis - Breath malodor
1Rechallenge
Rechallenge can lead to near-fatal or fatal relapse of AE/ILD
3Rechallenge can lead to relapse of AE/ILD
4Tolerance can be induced successfully starting with minute dosage of the drug
0Rechallenge can be monitored using biomarker or biomarkers
0Rechallenge may not lead to relapse of the AE/ILD
3