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
Lenalidomide Induced Late-Onset Acute Respiratory Distress Syndrome.
The Eurasian journal of medicine 2016 Oct;48;228-229 — 2016 Oct — 228-229
Pulmonary toxicity after long-term treatment with lenalidomide in two myeloma patients.
European respiratory review : an official journal of the European Respiratory Society 2013 Mar 01;22;93-5 — 2013 Mar 01 — 93-5
Drug-induced interstitial pneumonitis due to low-dose lenalidomide.
Internal medicine (Tokyo, Japan) 2012;51;1081-5 — 2012 — 1081-5
Interstitial pneumonitis associated with the immunomodulatory drugs thalidomide and lenalidomide.
International journal of hematology 2012 Feb;95;223-4 — 2012 Feb — 223-4
Zagouri F, Roussou M, Kastritis E, Koureas A, Tsokou E, Migkou M, Gavriatopoulou M, Nikitas N, Gkotzamanidou M, Terpos E, Dimopoulos MA
Lenalidomide-associated pneumonitis in patients with plasma cell dyscrasias.
American journal of hematology 2011 Oct;86;882-4 — 2011 Oct — 882-4
Reversible pulmonary toxicity due to lenalidomide.
Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2012 Jun;18;284-6 — 2012 Jun — 284-6
A case of lenalidomide-induced hypersensitivity pneumonitis.
Onkologie 2010;33;249-52 — 2010 — 249-52
Lenalidomide-induced interstitial lung disease.
Pharmacotherapy 2010 Mar;30;325 — 2010 Mar — 325
Hypersensitivity pneumonitis-like syndrome associated with the use of lenalidomide.
Chest 2007 May;131;1572-4 — 2007 May — 1572-4
Rajkumar SV, Hayman SR, Lacy MQ, Dispenzieri A, Geyer SM, Kabat B, Zeldenrust SR, Kumar S, Greipp PR, Fonseca R, Lust JA, Russell SJ, Kyle RA, Witzig TE, Gertz MA
Combination therapy with lenalidomide plus dexamethasone (Rev/Dex) for newly diagnosed myeloma.
Blood 2005 Dec 15;106;4050-3 — 2005 Dec 15 — 4050-3