Pneumotox » Drug » Bevacizumab

Bevacizumab

No undisputable evidence for bevacizumab-induced ILD as of Oct, 2014

Last update : 05/01/2020

I.b Pneumonitis (ILD)

II.b ARDS - Acute lung injury

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

III.c Hemoptysis

III.g Bleeding/hemorrhage from/around preexisting lung tumor (Localized AH)

III.h Major/massive hemoptysis

III.k Epistaxis

IV.a Bronchospasm - Wheezing - Asthma

V.f Pneumothorax

VI.a Pulmonary embolism - Venous thrombosis/thromboembolism

VI.b Pulmonary arterial hypertension

VIII.o Perforation of the nasal septum

VIII.r Tracheal/large airway necrosis, chondronecrosis, perforation

VIII.ab Airway (e.g. tracheoesophageal) fistula

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

X.s Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive

XI.w Cavitation/necrosis of lung tumor or metastases

XII.a Left or biventricular dysfunction/failure

XII.e Takotsubo (stress) cardiomyopathy

XII.f Cardiomyopathy (acute, subacute, chronic)

XII.g Coronary artery disease (acute) - Myocardial ischemia/infarction

XII.ai Cardiotoxicity

XII.aj Systemic arterial thrombosis

XII.at Aortitis

XVI.ab Imaging: Cavitating/cavitary lung nodule, mass or nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)

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

XVI.bf Imaging: Tumoral cavitation

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