Pneumotox » Drug » Gefitinib

Gefitinib

See PMID 20016372. The huge majority of cases emanate from Asia

Last update : 19/04/2019

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

I.b Pneumonitis (ILD)

I.g Pulmonary fibrosis

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

II.b ARDS - Acute lung injury

III.a Alveolar hemorrhage (AH), diffuse AH (DAH)

V.f Pneumothorax

V.ab Pneumothorax, bilateral

XI.w Cavitation/necrosis of lung tumor or metastases

XII.d Myocarditis (can be fulminant)

XII.ax Necrotizing myocarditis (w/o evidence for CAD)

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

XV.j Path: Pulmonary fibrosis (UIP-pattern)

XV.ce Path: Necrotizing myocarditis

XVI.b Imaging: Ground-glass opacities (GGO) / shadowing

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

XIX.a BAL: An excess proportion of lymphocytes

XIX.c BAL: An excess proportion of eosinophils

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