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
Docetaxel-induced interstitial lung disease among patients with breast cancer: a case series and review of literature.
Respirology case reports 2021 Jul;9;e00802 — 2021 Jul — e00802
Docetaxel-induced hypersensitivity pneumonitis mimicking lymphangitic carcinomatosis in a patient with metastatic adenocarcinoma of the lung.
Hematology/oncology and stem cell therapy 2013 Sep-Dec;6;117-9 — 2013 Sep-Dec — 117-9
Tamiya A, Naito T, Miura S, Morii S, Tsuya A, Nakamura Y, Kaira K, Murakami H, Takahashi T, Yamamoto N, Endo M
Interstitial lung disease associated with docetaxel in patients with advanced non-small cell lung cancer.
Anticancer research 2012 Mar;32;1103-6 — 2012 Mar — 1103-6
Docetaxel and interstitial pulmonary injury.
Annals of oncology : official journal of the European Society for Medical Oncology 1997 Feb;8;191-4 — 1997 Feb — 191-4