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 (ILD), acute and/or severe (may produce the ARDS pattern)

I.b

Pneumonitis (interstitial lung disease/ILD)

I.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

I.d

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

I.f

Acute fibrinous organizing pneumonia (AFOP)

I.g

Pulmonary fibrosis

I.k

Lung nodule or nodules

I.l

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

I.p

Fatal pneumonitis (ILD)

I.v

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

I.w

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

II - Pulmonary edema - Acute lung injury - ARDS

II.b

ARDS - Acute lung injury

II.t

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

V - Pleural and/or pericardial involvement

V.f

Pneumothorax

V.p

Pleuroparenchymal fibroelastosis (PPFE)

V.z

Pneumothorax (associated or secondary to drug-induced ILD)

VI - Pulmonary vasculopathy

VI.c

Pulmonary veno-occlusive disease

VI.f

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

VII - Mediastinal involvement

VII.e

Granulomatous mediastinal lymphadenopathy

VII.h

Pneumomediastinum

XI - Miscellaneous

XI.b

Chest pain (acute or subacute), lone or prominent

XI.c

Pleuritic chest pain

XV - Pathology

XV.a

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

XV.b

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

XV.c

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

XV.d

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

XV.f

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

XV.h

Path: NSIP-fibrotic pattern

XV.i

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

XV.j

Path: Pulmonary fibrosis (UIP-pattern)

XV.l

Path: Pulmonary fibrosis (not otherwise specified or unclassifiable)

XV.ax

Path: Focal organizing pneumonia

XV.be

Path: Interstitial pulmonary edema

XV.bf

Path: Pulmonary necrotizing granuloma or granulomas

XVI - Imaging

XVI.a

Imaging: Diffuse haze

XVI.b

Imaging: Ground-glass opacities (GGO) / shadowing

XVI.e

Imaging: Pulmonary opacities with a subpleural distribution

XVI.k

Imaging: An area or areas of consolidation

XVI.w

Imaging: Lung nodule or nodules

XVI.ab

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

XVI.af

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

XVI.bl

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

XVIII - Distinctive patterns - 'Eye-catchers'

XVIII.j

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

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

XIX.b

BAL: An excess proportion of neutrophils

XXIV - Veterinary medicine

XXIV.a

Veterinary: Pneumonitis - Interstitial lung disease

XXIV.b

Veterinary: Pulmonary fibrosis