The Drug-Induced Respiratory Disease Website

Atezolizumab

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

Can be refractory to corticosteroids (PMID 30837232)

Li R, Lee G, El-Sherief A

Immunotherapy causing pneumonitis in a patient with non-small cell lung cancer (NSCLC).

BMJ case reports 2019 Mar 04;12; — 2019 Mar 04

Shannon VR

Pneumotoxicity associated with immune checkpoint inhibitor therapies.

Current opinion in pulmonary medicine 2017 07;23;305-316 — 2017 07 — 305-316

Tabchi S, Messier C, Blais N

Immune-mediated respiratory adverse events of checkpoint inhibitors.

Current opinion in oncology 2016 07;28;269-77 — 2016 07 — 269-77

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

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