The Drug-Induced Respiratory Disease Website

Alectinib

Subclinical pulmonary infiltrates/ILD

(Fr. atteinte infraclinique). Interstitial or alveolar opacities detected incidentally on HRCT or if the BAL shows increased lymphocytes, neutrophils or eosinophils. PFTs typically yield normal results. See also under Iv

Publications

Chen X, Xia D, Jiang X, Cao L, Ryu JH, Hu X

Case report: Indolent drug-related pneumonitis with alectinib therapy in the treatment of non-small cell lung cancer.

Frontiers in pharmacology 2022;13;944685 — 2022 — 944685

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

Diagnosing DIRD

Identify causative drugs

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