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
Interstitial Pneumonitis Secondary to Trastuzumab: A Case Report and Literature Review.
Case reports in oncology 2017 May-Aug;10;524-530 — 2017 May-Aug — 524-530
Delayed Paclitaxel-trastuzumab-induced interstitial pneumonitis in breast cancer.
Case reports in oncology 2011 Apr 02;4;186-91 — 2011 Apr 02 — 186-91
Trastuzumab: unusual responses and toxicities.
Future oncology (London, England) 2009 Aug;5;779-84 — 2009 Aug — 779-84
A case of interstitial pneumonitis associated with Guillain-Barré syndrome during administration of adjuvant trastuzumab.
Tumori 2008 Sep-Oct;94;737-41 — 2008 Sep-Oct — 737-41
Post-marketing safety of antineoplasic monoclonal antibodies: rituximab and trastuzumab.
Pharmacoepidemiology and drug safety 2008 Jul;17;714-21 — 2008 Jul — 714-21