The Drug-Induced Respiratory Disease Website and App

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

IV.c

Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx)

Of the three cases described (PMID 22616969, 28279286, Martires et al. Constrictive bronchiolitis and organizing pneumonia associated with rituximab. Chest, 2013. 144 (4_MeetingAbstracts): p. 671A (unpublished as of July, 2019)), all three had a Hx of lymphoma. In none of these three cases were immunoglobulin levels mentioned. As rituxumab may induce hypogammaglobilinemia, post-rituximab bronchiolitis/BO may reflect pulmonary expression/complications of acquired immunoglobulin deficiency rather than be a direct toxic effect of the medication

Publications

Nishihara T, Nakano H, Nogami H, Katahira K, Ishimatsu A, Hashimoto N, Yokoi T, Iwanaga T

A 63-Year-Old Woman With Progressive Dyspnea After Remission of Lymphoma.

Chest 2017 Mar;151;e57-e62 — 2017 Mar — e57-e62

Shen T, Braude S

Obliterative bronchiolitis after rituximab administration: a new manifestation of rituximab-associated pulmonary toxicity.

Internal medicine journal 2012 May;42;597-9 — 2012 May — 597-9