The Drug-Induced Respiratory Disease Website
Or 'ILD'. (Fr: PnP subaiguë). A.k.a. pulmonary infiltrates. Generally bilateral and symmetrical. Gradual onset. Consistent with but not specific for an NSIP-c pattern on pathology. Less- dense, severe, acute and diffuse than pattern Ia. Lacks the features of ARDS that may accompany pattern Ia. Can be in the form of disseminated linear, reticulonodular, miliary or patchy opacities. BAL is indicated to separate this pattern from PIE (Ic) or DAH (IIIa). Acute chest pain can be at the forefront. A search for microorganisms including Pneumocystis (stains, PCR) is indicated. On pathology (although not many cases undergo a confirmatory lung biopsy), there is interstitial inflammation and a more or less dense cellular interstitial cellular infiltrate (NSIP-c). Fibrosis, alveolar edema and/or a reactive epithelium denote those cases resulting from with antineoplastic chemotherapy agents. The frontier between patterns Ia and I b can be difficult to draw, so please check drugs under both Ia and Ib. Patients may quickly shift from pattern Ib to Ia particularly if the the causal drug is inappropriately continued. Prompt withdrawal must be considered, underlying disease permitting, and can be therapeutic.
Publications
Méndez-Echevarría A, Fernandez-Prieto A, de la Serna O, Lopez-Gutierrez JC, Parron M, Marin-Aguilera B, Calvo C
Acute Lung Toxicity After Intralesional Bleomycin Sclerotherapy.
Pediatrics 2018 01;141; — 2018 01
Pulmonary toxicity following bleomycin use: A single-center experience.
Journal of cancer research and therapeutics 2017 Jul-Sep;13;466-470 — 2017 Jul-Sep — 466-470
Incidence, outcome and predictors of bleomycin pulmonary toxicity in a university hospital in Oman.
Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2013 Mar;19;3-7 — 2013 Mar — 3-7
Prognostic impact of bleomycin-induced pneumonitis on the outcome of Hodgkin's lymphoma.
Annals of hematology 2011 Jan;90;67-72 — 2011 Jan — 67-72
Bleomycin pulmonary toxicity has a negative impact on the outcome of patients with Hodgkin's lymphoma.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2005 Oct 20;23;7614-20 — 2005 Oct 20 — 7614-20
Pulmonary complications associated with combination chemotherapy programs containing bleomycin.
The American journal of medicine 1983 Apr;74;557-63 — 1983 Apr — 557-63
Pulmonary complications of chemotherapy regimens containing bleomycin.
AJR. American journal of roentgenology 1982 Sep;139;455-61 — 1982 Sep — 455-61
Fatal bleomycin toxicity from a low cumulative dose in a patient with renal insufficiency.
Cancer 1987 Dec 01;60;2617-20 — 1987 Dec 01 — 2617-20
Bleomycin-induced nodular pulmonary fibrosis masquerading as metastatic testicular cancer.
The Journal of urology 1986 Aug;136;473-5 — 1986 Aug — 473-5