The Drug-Induced Respiratory Disease Website

Infliximab

Pneumonitis (ILD), acute and/or severe (may cause ARDS)

Causality assessment can be problematic in patients on concomitant infliximab and methotrexate or azathioprine

Publications

Rofaiel R, Kohli S, Mura M, Hosseini-Moghaddam SM

A 53-year-old man with dyspnoea, respiratory failure, consistent with infliximab-induced acute interstitial pneumonitis after an accelerated induction dosing schedule.

BMJ case reports 2017 May 12;2017; — 2017 May 12

Schoehl J, Mechie NC, Schwoerer H, Moerer O, Quintel M, Buck C, Ellenrieder V, Neesse A, Amanzada A

Severe Acute Respiratory Distress Syndrome during Infliximab Therapy in a Patient with Crohn Disease.

Case reports in gastroenterology 2016 Sep-Dec;10;574-580 — 2016 Sep-Dec — 574-580

Bale J, Chee P

Acute alveolitis following infliximab therapy for psoriasis.

The Australasian journal of dermatology 2013 Feb;54;61-3 — 2013 Feb — 61-3

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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