The Drug-Induced Respiratory Disease Website and App

Infliximab

Hypesrentitivity infusion reactions are common (PMID 12818276). For those ILD cases exposed to methotrexate concomitantly, drug causality assessment in regards to infliximab is difficult.

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

I - Interstitial/parenchymal lung disease

I.a

Pneumonitis (interstitial lung disease/ILD)

I.b

Pneumonitis (ILD), acute and/or severe (may cause ARDS)

I.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

I.d

Acute eosinophilic pneumonia (AEP)

I.e

Organizing pneumonia pattern (an area or areas of consolidation on imaging)

I.g

Pulmonary fibrosis

I.x

Rapidly progressive ILD/pulmonary fibrosis (Hamman-Rich syndrome)

I.z

Progression, acceleration or exacerbation of preexisting ILD/fibrosis

XLI - Pulmonary edema - Acute lung injury - ARDS

XLI.e

ARDS - Acute lung injury

XLII - Pulmonary/alveolar./airway hemorrhage/bleeding

XLII.a

Alveolar hemorrhage (AH), diffuse AH (DAH)

XLIII - Airway involvement

XLIII.a

Bronchospasm - Wheezing - Asthma

XLV - Pleural and/or pericardial involvement

XLV.a

Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

XLV.d

Pleural/pericardial effusion, ANA positive (DI lupus)

XLVI - Pulmonary vasculopathy

XLVI.a

Pulmonary embolism - Venous thrombosis/thromboembolism

XLVI.d

Pulmonary vasculitis or capillaritis

XLIX - Systemic/Distant conditions, syndromes and reactions

XLIX.a

DRES syndrome - DRESS-like reaction

XLIX.b

Antiphospholipid antibodies w/wo the APL syndrome

XLIX.d

Lupus - Lupus syndrome (see also Vd)

XLIX.e

Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs)

XLIX.f

Anaphylaxis-Anaphylactoid reaction (can be fatal)

XLIX.i

Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement)

XLIX.j

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

XLIX.l

Myopathy-Myositis-Polymyositis (see also under Xba)

XLIX.m

Sarcoid-like granulomatosis (endo-/extrathoracic)

XLIX.u

Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive

XLIX.aj

Granulomatosis with polyangiitis (typically ANCA pos.) - GPA flare

XLIX.at

Relapse/flare/onset of Crohn's disease

LI - Cardiovascular involvement / toxicity

LI.c

Pericardial effusion (w/wo tamponade)

LI.d

Myocarditis (can be fulminant)

LI.r

Pericarditis (see also under XIIc)

LI.bt

Right ventricular thrombus/thrombosis

LV - Imaging

LV.b

Imaging: Ground-glass opacities (GGO) / shadowing

LVIII - Pathology

LVIII.a

Path: NSIP-cellular pattern (see also Ia, Ib)

LVIII.o

Path: Diffuse alveolar damage (DAD-pattern) (see also IL)

LVIII.bo

Path: Pleural granulomas

LIX - Infections & related conditions

LIX.b

Opportunistic pulmonary/systemic infections

LIX.c

Aspergillosis, pulmonary (invasive, allergic [ABPA], or mycetoma)

LIX.d

Pneumocystis jiroveci pulmonary colonization

LIX.e

Pneumocystis jiroveci pneumonia

LIX.f

Tuberculosis, miliary

LIX.g

Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo

LIX.h

Nontuberculous pulmonary mycobacterial infection/superinfection

LIX.n

Legionella pneumophila pneumonia

LIX.o

Nocardia pulmonary/systemic infection

LIX.q

Viral pneumonia

LIX.r

Fungal infection (pulmonary/extrapulmonary)

LIX.x

Cryptococcus pulmonary and/or systemic infection

LIX.y

Histoplamosis (reactivation)

LIX.ab

Actinomycosis