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
Drug-induced interstitial lung disease: Indictment for apixaban.
Respiratory medicine and research 2023 May 19;84;101024 — 2023 May 19 — 101024
A case of apixaban-associated idiopathic interstitial pneumonia.
Cardiology journal 2022;29;364-365 — 2022 — 364-365
Direct Oral Anticoagulants and Interstitial Lung Disease: Emerging Clues from Pharmacovigilance.
Drug safety 2020 11;43;1191-1194 — 2020 11 — 1191-1194
Tomari S, Homma K, Noguchi T, Aiba T, Matsuki T, Suzuki R, Koga M, Takigami M, Tagawa H, Hashimoto T, Toyoda K
Development of Interstitial Lung Disease after Initiation of Apixaban Anticoagulation Therapy.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2016 Jul;25;1767-1769 — 2016 Jul — 1767-1769