Pneumotox » Drug » Interferon alpha/beta

Interferon alpha/beta

Group I interferon including pegylated IFN

Last update : 21/11/2013

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

I.b Pneumonitis (ILD)

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

I.g Pulmonary fibrosis

I.m ILD with a granulomatous component

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

I.y Progression, acceleration or exacerbation of preexisting ILD/fibrosis

II.a Pulmonary edema, noncardiogenic (NCPE)

II.b ARDS - Acute lung injury

IV.a Bronchospasm - Wheezing - Asthma

IV.d Cough (lone)

IV.w Plugs/casts in the airways

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

VI.b Pulmonary arterial hypertension

VI.d Pulmonary vasculitis or capillaritis

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

VII.a Lymphadenopathy (intrathoracic)

VII.e Granulomatous mediastinal lymphadenopathy

VIII.a Angioedema (may cause UAO, asphyxia and death)

X.b Antiphospholipid antibodies w/wo the APL syndrome

X.c Capillary leak syndrome (CLS)

X.d Lupus - Lupus syndrome (see also Vd)

X.f Anaphylaxis-Anaphylactoid reaction (can be fatal)

X.j Myopathy-Myositis-Polymyositis (see also under Xba)

X.k Sarcoid-like granulomatosis (endo-/extrathoracic)

X.u Multiple organ dysfunction/failure (MODS/MOF)

XI.n Neutropenia, agranulocytosis (w/wo infection/sepsis)

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

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

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

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

XV.k Path: Desquamative interstitial pneumonia (DIP-pattern)

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

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

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

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

More detailed checklist

The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France