Pneumotox » Drug » Bortezomib

Bortezomib

Pulmonary complications from bortezomib are unusual in the West and have been mainly described in Japan and Asia. The respective role of ethnicity, case definition and other confounding factors cannot be assessed at the present time

Last update : 15/01/2016

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.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)

VI.b Pulmonary arterial hypertension

X.c Capillary leak syndrome (CLS)

X.n Tumor lysis syndrome (TLS)

X.o Neutrophilic dermatosis (Pyoderma, Sweet syndrome)

XII.a Left or biventricular dysfunction/failure

XII.f Cardiomyopathy (acute, subacute, chronic)

XII.s Heart block (bundle branch- or AV-)

XII.ai Cardiotoxicity

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

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

XVII.e Pneumocystis jiroveci pneumonia

XVII.h Nontuberculous pulmonary mycobacterial infection/superinfection

XVII.j Mucormycosis (pulmonary, tracheobronchial or systemic)

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