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Vedolizumab

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Last update : 14/04/2021

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

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I.b Pneumonitis (ILD)

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I.c Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

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

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I.k Lung nodule or nodules

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II.b ARDS - Acute lung injury

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

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VIII.aq Bronchorrhea

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

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X.o Neutrophilic dermatosis (Pyoderma, Sweet syndrome)

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

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

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XV.e Path: ILD with a granulomatous component (see also Im)

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XV.x Path: Acute/subacute bronchiolitis (see also IVc, IVi)

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XV.cn Path: Pulmonary necrotizing granuloma with neutrophilic microabscesses

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XVI.g Imaging: Diffuse whiteout/alveolar shadowing (see also under IIb-ARDS)

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XVI.v Imaging: Centrilobular micronodules (can be diffuse)

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XVII.a Respiratory tract infection incl. pneumonia

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XVII.v Strongyloides stercoralis hyperinfection (w/wo DAH)

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XXI.b Rechallenge can lead to relapse of AE/ILD

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Diagnosing DIRD

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Drug and radiation history

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Drug singularity - Correct identification of the drug

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Consistent timing of exposure v. onset of symptoms

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Clinical, imaging, BAL, pathological pattern consistent with the specific drug

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Careful exlusion of another cause

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Remission of symptoms with removal of drug

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Recurrence with rechallenge (rarely advisable)

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Causality assessment

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