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
Imakura T, Sato S, Tomonari T, Murakami K, Takahashi N, Naito N, Mima M, Kagawa K, Koyama K, Nishimura H, Kawano H, Nokihara H, Azuma M, Takayama T, Nishioka Y
A Case of Lenvatinib-induced Interstitial Pneumonia in a Patient with Hepatocellular Carcinoma.
Internal medicine (Tokyo, Japan) 2021 Sep 18;; — 2021 Sep 18
Kotani K, Enomoto M, Okada M, Yoshida K, Motoyama H, Fujii H, Hagihara A, Uchida-Kobayashi S, Morikawa H, Murakami Y, Tamori A, Kawada N
Interstitial pneumonia suspected during regorafenib administration and exacerbated by subsequent therapy with lenvatinib for unresectable hepatocellular carcinoma.
Clinical journal of gastroenterology 2019 Apr 24;; — 2019 Apr 24
Kimura-Tsuchiya R, Sasaki E, Nakamura I, Suzuki S, Kawana S, Okouchi C, Fukushima T, Hashimoto Y, Suzuki S, Saji S
A Case of Squamous Cell Carcinoma of Unknown Primary that Responded to the Multi-Tyrosine Kinase Inhibitor Lenvatinib.
Case reports in oncology 2018;11;75-80 — 2018 — 75-80