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Dasatinib

Management of dasatinib-induced pleural effusion at PMID 20375898

Last update : 28/10/2014

I.b Pneumonitis (ILD)

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

I.n Pulmonary alveolar proteinosis (PAP)

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

II.a Pulmonary edema, noncardiogenic (NCPE)

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

V.c Pleural thickening - Fibrothorax

V.d Pleural/pericardial effusion, ANA positive (DI lupus)

V.h Chylothorax

V.i Pleuritis (can cause chest pain)

V.m Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative)

VI.b Pulmonary arterial hypertension

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

X.r Fluid retention

XI.b Chest pain (acute or subacute), lone or prominent

XII.c Pericardial effusion (w/wo tamponade)

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

XV.n Path: Pulmonary alveolar proteinosis pattern (PAP pattern)

XV.ao Path: Pleuritis, pleural fibrosis

XV.ch Path: Organizing fibrinous pleuritis (OFP)

XVI.m Imaging: Interlobular septal thickening

XVI.an Imaging: Pleural effusion

XIX.a BAL: An excess proportion of lymphocytes

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