The Drug-Induced Respiratory Disease Website
(Fr: PINS aiguë). Acute, generally bilateral and diffuse pneumonitis. More rapid in onset and/or denser, more extensive and severe than pattern Ib. Can be fulminate in the form of diffuse pulmonary interstitial or alveolar opacities and the ARDS picture (see under IIb). BAL is generally lymphocytic and is also indicated to rule out pneumonia due to Pneumocystis, BCG, viruses or other agents particularly in the immunodepressed. Pathology (lung biopsy is not necessary in the majority; before going for the biopsy, please look at PMID 25950989) may disclose dense NSIP, widespread granulomas, or OP depending both on patient and drug. In severe cases pulmonary edema, DAD and/or DAH may develop. Corticosteroid therapy is indicated if patients progress to acute respiratory failure, once an infection has been carefully and resonably ruled out. Transition to pulmonary fibrosis is very uncommon. The boundary between patterns Ia and Ib may be difficult to delineate. See also under IIb
Publications
Drug-induced interstitial pneumonia after intravesical Bacillus Calmette-Guerin administration for bladder cancer with scleroderma.
IJU case reports 2023 Mar;6;133-136 — 2023 Mar — 133-136
Pommier JD, Ben Lasfar N, Van Grunderbeeck N, Burdet C, Laouénan C, Rioux C, Pierre-Audigier C, Meybeck A, Choudat L, Benchikh A, Nguyen S, Bouvet E, Yeni P, Yazdanpanah Y, Joly V
Complications following intravesical bacillus Calmette-Guerin treatment for bladder cancer: a case series of 22 patients.
Infectious diseases (London, England) 2015;47;725-31 — 2015 — 725-31
Caramori G, Artioli D, Ferrara G, Cazzuffi R, Pasquini C, Libanore M, Guardigni V, Guzzinati I, Contoli M, Rossi R, Rinaldi R, Contini C, Papi A
Severe pneumonia after intravesical BCG instillation in a patient with invasive bladder cancer: case report and literature review.
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace 2013 Mar;79;44-8 — 2013 Mar — 44-8
Multi-organ failure with atypical liver granulomas following intravesical Bacillus Calmette-Guerin instillation.
World journal of hepatology 2011 Mar 27;3;79-82 — 2011 Mar 27 — 79-82
Diffuse alveolar damage in BCGosis: a rare complication of intravesical bacillus Calmette-Guérin therapy for transitional cell carcinoma.
Pathology 1999 Feb;31;55-6 — 1999 Feb — 55-6
Bacillus Calmette-Guerin (BCG) immunotherapy for bladder cancer: review of complications and their treatment.
The Australian and New Zealand journal of surgery 1998 May;68;340-4 — 1998 May — 340-4