Pneumotox » Drug » Status post-hematopoietic stem cell (HSCT) or bone marrow transplantation (BMT)

Status post-hematopoietic stem cell (HSCT) or bone marrow transplantation (BMT)

5

Transplantation of stem cells from bone marrow, peripheral or umbilical chord blood and status post-HSCT. The responsibility of chemotherapy drugs, blood transfusion, radiation, marrow/stem cell infusion, GVHD must be carefully weighed. An infection must also be considered and carefully ruled out. See PMID 11593314, 16412788, 23340330, 23375643

Last update : 01/02/2016

I.b Pneumonitis (ILD)

5

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

2

I.f Acute fibrinous organizing pneumonia (AFOP)

1

I.g Pulmonary fibrosis

4

I.n Pulmonary alveolar proteinosis (PAP)

1

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

3

I.x Pleuroparenchymal fibroelastosis (PPFE)

2

II.a Pulmonary edema, noncardiogenic (NCPE)

2

II.e Transfusion-related acute lung injury (TRALI) (May cause ARDS)

2

II.n Engraftment syndrome

3

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

3

IV.c Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx)

5

IV.m Bronchial stenosis/stricture

1

V.f Pneumothorax

2

VI.b Pulmonary arterial hypertension

1

X.c Capillary leak syndrome (CLS)

2

XII.a Left or biventricular dysfunction/failure

1

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

1

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

2

XV.d Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also If)

1

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

2

XV.g Path: Alveolar hemorrhage (see also IIIa)

2

XV.ak Path: Pulmonary veno-occlusive disease (PVOD)

1

XV.ap Path: Pleuroparenchymal fibrosis/fibroelastosis (PPFE)

1

XV.bv Path: Pulmonary cytolytic thrombi

1

XVI.w Imaging: Lung nodule or nodules

2

XVII.m Fungal airway infection

1

Diagnosing DIRD

1

Drug and radiation history

2

Drug singularity - Correct identification of the drug

3

Consistent timing of exposure v. onset of symptoms

4

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

5

Careful exlusion of another cause

6

Remission of symptoms with removal of drug

7

Recurrence with rechallenge (rarely advisable)

8

Causality assessment

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