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
Stelara struck: a case of noninfectious pneumonitis secondary to ustekinumab.
BMC pulmonary medicine 2022 Jul 19;22;280 — 2022 Jul 19 — 280
The risk of interstitial lung disease during biological treatment in Japanese patients with psoriasis.
Clinical and experimental dermatology 2020 Oct;45;853-858 — 2020 Oct — 853-858
[Drug-induced interstitial lung disease (DILD) during treatment with ustekinumab].
Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete 2019 Dec 02;; — 2019 Dec 02
Association of Noninfectious Pneumonia With Ustekinumab Use.
JAMA dermatology 2018 Dec 12;; — 2018 Dec 12
Paradoxical exacerbation of latent interstitial pneumonia by secukinumab in a patient with psoriasis vulgaris.
The British journal of dermatology 2019 Mar;180;684-685 — 2019 Mar — 684-685
A Case of Interstitial Lung Disease and Autoimmune Thyroiditis Associated with Ustekinumab.
Acta dermato-venereologica 2019 Mar 01;99;331-332 — 2019 Mar 01 — 331-332
Stop Being So Sensitive: An Exceptionally Rare Report of Ustekinumab-Induced Sub-acute Hypersensitivity Pneumonitis.
Turkish journal of anaesthesiology and reanimation 2017 Oct;45;313-317 — 2017 Oct — 313-317
Interstitial pneumonia in two patients with psoriasis during ustekinumab treatment.
The Journal of dermatology 2016 Jun;43;712-3 — 2016 Jun — 712-3