The Drug-Induced Respiratory Disease Website

Azacitidine

Pneumonitis (ILD)

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

Alyamany R, Alnughmush A, Almutlaq M, Alyamany M, Alfayez M

Azacitidine induced lung injury: report and contemporary discussion on diagnosis and management.

Frontiers in oncology 2024;14;1345492 — 2024 — 1345492

Litvin R, Dasgupta M, Saad Eldin M, Shah M, Fakhran S

Azacitidine-Induced Pneumonitis in a Patient With Acute Myeloid Leukemia and Hyperleukocytosis.

Cureus 2022 Jul;14;e26758 — 2022 Jul — e26758

Molina M, Yellapragada S, Mims M, Rahman E, Rivero G

Pulmonary Complications of Azanucleoside Therapy in Patients with Myelodysplastic Syndrome and Acute Myelogenous Leukemia.

Case reports in hematology 2015;2015;357461 — 2015 — 357461

Verriere B, Ferreira V, Denis E, Zahreddine K, Deletie E, Quinsat D, Re D

Azacitidine-Induced Interstitial Pneumonitis.

American journal of therapeutics 2016 Sep-Oct;23;e1205-8 — 2016 Sep-Oct — e1205-8

Hayashi M, Takayasu H, Tada M, Yamazaki Y, Tateno H, Tazawa S, Wakabayashi A, Iwasaki T, Tsuchiya Y, Yamashita J, Takeda N, Tomita S, Mori H, Kokubu F

Azacitidine-induced pneumonitis in a patient with myelodysplastic syndrome: first case report in Japan.

Internal medicine (Tokyo, Japan) 2012;51;2411-5 — 2012 — 2411-5

Hueser CN, Patel AJ

Azacitidine-associated hyperthermia and interstitial pneumonitis in a patient with myelodysplastic syndrome.

Pharmacotherapy 2007 Dec;27;1759-62 — 2007 Dec — 1759-62

Diagnosing DIRD