The Drug-Induced Respiratory Disease Website and App

Bleomycin

Cases are still being reported. 2013 review on BPT can be found under PMID 23312772

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.e

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

I.f

Acute fibrinous organizing pneumonia (AFOP)

I.g

Pulmonary fibrosis

I.l

Lung nodule or nodules

I.m

Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf)

I.q

Fatal pneumonitis (ILD)

I.w

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

I.x

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

XLI - Pulmonary edema - Acute lung injury - ARDS

XLI.e

ARDS - Acute lung injury

XLI.u

Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO

XLV - Pleural and/or pericardial involvement

XLV.f

Pneumothorax

XLV.p

Pleuroparenchymal fibroelastosis (PPFE)

XLV.aa

Pneumothorax (associated or secondary to drug-induced ILD)

XLVI - Pulmonary vasculopathy

XLVI.c

Pulmonary veno-occlusive disease

XLVI.f

Hemolytic and uremic syndrome (HUS). See also under Xaf

XLVII - Mediastinal involvement

XLVII.e

Granulomatous mediastinal lymphadenopathy

XLVII.h

Pneumomediastinum

L - Miscellaneous

L.b

Chest pain (acute or subacute), lone or prominent

L.c

Pleuritic chest pain

LV - Imaging

LV.a

Imaging: Diffuse haze

LV.b

Imaging: Ground-glass opacities (GGO) / shadowing

LV.e

Imaging: Pulmonary opacities with a subpleural distribution

LV.k

Imaging: An area or areas of consolidation

LV.w

Imaging: Lung nodule or nodules

LV.ac

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

LV.ad

Imaging: Lung cysts or bullae (see also XVI ah/bf)

LV.bp

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

LVI - Distinctive patterns - 'Eye-catchers'

LVI.j

Eye-catcher: Avid lung uptake on 18F-PET-CT

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

LVII.b

BAL: An excess proportion of neutrophils

LVIII - Pathology

LVIII.a

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

LVIII.b

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

LVIII.d

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

LVIII.e

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

LVIII.g

Path: Pulmonary necrotizing granuloma or granulomas

LVIII.i

Path: Focal organizing pneumonia

LVIII.o

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

LVIII.q

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

LVIII.u

Path: Interstitial pulmonary edema

LVIII.v

Path: NSIP-fibrotic pattern

LVIII.w

Path: Pulmonary fibrosis (UIP-pattern)

LVIII.x

Path: Pulmonary fibrosis (not otherwise specified or unclassifiable)

LXV - Veterinary medicine

LXV.a

Veterinary: Pneumonitis - Interstitial lung disease

LXV.d

Veterinary: Pulmonary fibrosis