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
Nakayama S, Yoshizawa A, Tsurutani J, Yoshimura K, Aoki G, Iwamoto T, Nagase H, Sugimoto N, Kobayashi K, Izumi S, Kato T, Miyazaki Y, Kurihara Y, Taira N, Aihara T, Kikawa Y, Mukai H
Real-world incidence of and risk factors for abemaciclib-induced interstitial lung disease in Japan: a nested case-control study of abemaciclib-induced interstitial lung disease (NOSIDE).
Breast cancer (Tokyo, Japan) 2025 Jan;32;177-185 — 2025 Jan — 177-185
Radiation Pneumonitis, Really? A Case of Pulmonary Toxicity from CDK4/6 Inhibitor.
Anticancer research 2023 Aug;43;3539-3542 — 2023 Aug — 3539-3542
Clinicoradiological course of abemaciclib-induced pneumonitis with histology findings.
BMJ case reports 2023 May 02;16; — 2023 May 02
Can CDK4/6 inhibitors cause fatal lung injury?
Expert review of anticancer therapy 2019 11;19;917-919 — 2019 11 — 917-919