The Drug-Induced Respiratory Disease Website and App

Radiation therapy (early effects)

To the chest. Changes are usually ipsilateral to the irradiated side except in acute radiation pneumoniitis and in radiation-elicited BOOP

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 (ILD)

I.b

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

I.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

I.e

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

I.w

Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence

I.z

Progression, acceleration or exacerbation of preexisting ILD/fibrosis

I.ac

Radiation-induced lung injury (RILI)

I.ad

Acute radiation pneumonitis

II - Pulmonary edema - Acute lung injury - ARDS

II.e

ARDS - Acute lung injury

V - Central-large-upper airway (incl. pharyngeal-nasal) involvement

V.c

Upper airway obstruction other than angioedema or hematoma

VI - Pleural and/or pericardial involvement

VI.a

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

VI.h

Chylothorax

IX - Neuromuscular / CNS involvement - Disordered breathing (during sleep)

IX.h

Dyspnea, unexplained otherwise

XI - Miscellaneous

XI.t

Cavitation/necrosis of lung tumor or metastases

XII - Cardiovascular involvement / toxicity

XII.l

Constrictive pericarditis - Pericardial thickening

XVI - Imaging

XVI.ac

Imaging: Cavitating/cavitary lung nodule, mass or nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)

XVI.bp

Imaging: An area or areas of avid tracer uptake in the lung/chest on 18F-PET scan

XVIII - Cytological, biochemical features of/in BAL, pleural fluid or FNA

XVIII.a

BAL: An excess proportion of lymphocytes

XVIII.c

BAL: An excess proportion of eosinophils

XIX - Pathology

XIX.a

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

XIX.b

Path: Eosinophilic pneumonia (subacute or acute) (see also Ic)

XIX.d

Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)

XIX.e

Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also If)

XIX.o

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

XIX.q

Path: Pneumocyte atypia (reactive epithelial cells) (a.k.a. the "Napoleon Hat" sign)

XIX.v

Path: NSIP-fibrotic pattern