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 pneumonia after intravesical Bacillus Calmette-Guerin administration for bladder cancer with scleroderma.
IJU case reports 2023 Mar;6;133-136 — 2023 Mar — 133-136
Spisarova M, Losse S, Jakubec P, Hartmann I, Kral M, Ehrmann J, Szkorupa M, Studentova H, Melichar B
Bacillus Calmette-Guérin pneumonitis after intravesical instillation: Report of two cases and a review of the literature.
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 2023 Jan 02;; — 2023 Jan 02
Pommier JD, Ben Lasfar N, Van Grunderbeeck N, Burdet C, Laouénan C, Rioux C, Pierre-Audigier C, Meybeck A, Choudat L, Benchikh A, Nguyen S, Bouvet E, Yeni P, Yazdanpanah Y, Joly V
Complications following intravesical bacillus Calmette-Guerin treatment for bladder cancer: a case series of 22 patients.
Infectious diseases (London, England) 2015;47;725-31 — 2015 — 725-31
BCG-induced pneumonitis with lymphocytic pleurisy in the absence of elevated KL-6.
BMC pulmonary medicine 2014 Mar 05;14;35 — 2014 Mar 05 — 35
Caramori G, Artioli D, Ferrara G, Cazzuffi R, Pasquini C, Libanore M, Guardigni V, Guzzinati I, Contoli M, Rossi R, Rinaldi R, Contini C, Papi A
Severe pneumonia after intravesical BCG instillation in a patient with invasive bladder cancer: case report and literature review.
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace 2013 Mar;79;44-8 — 2013 Mar — 44-8
Hypersensitivity pneumonitis following intravesical bacille Calmette-Guérin immunotherapy for superficial bladder cancer.
Journal of investigational allergology & clinical immunology 2009;19;230-2 — 2009 — 230-2
Severe complications following intravesical BCG instillation.
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace 2002 Oct-Dec;57;321-4 — 2002 Oct-Dec — 321-4
Miliary tuberculosis of the lung in a patient treated with bacillus Calmette-Guerin for superficial bladder cancer.
The Journal of urology 1998 May;159;1639-40 — 1998 May — 1639-40
Pulmonary complications of intravesical Bacille Calmette-Guérin immunotherapy.
The American review of respiratory disease 1987 Mar;135;763-5 — 1987 Mar — 763-5
Toxicity of intravesical BCG and its management in patients with superficial bladder tumors.
Cancer 1987 Aug 01;60;326-33 — 1987 Aug 01 — 326-33
Miliary Mycobacterium bovis induced by intravesical bacille Calmette-Guérin immunotherapy.
The American review of respiratory disease 1992 Nov;146;1330-3 — 1992 Nov — 1330-3