Pneumotox » Drug » Carbamazepine

Carbamazepine

3

See also other anticonvulsants

DRESS also described with oxcarbamazepine

Last update : 19/09/2012

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

1

I.b Pneumonitis (ILD)

1

I.c Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

2

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

1

I.k Lung nodule or nodules

1

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

1

II.a Pulmonary edema, noncardiogenic (NCPE)

1

II.b ARDS - Acute lung injury

1

IV.a Bronchospasm - Wheezing - Asthma

1

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

1

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

1

VII.a Lymphadenopathy (intrathoracic)

2

VII.b Lymphadenopathy with reactive changes

2

X.a DRES syndrome - DRESS-like reaction

3

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

2

X.m Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative)

1

XII.a Left or biventricular dysfunction/failure

1

XII.c Pericardial effusion (w/wo tamponade)

1

XII.d Myocarditis (can be fulminant)

1

XII.l Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)

1

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

1

XIII.b Lymphoproliferative disease (pulmonary, endobronchial, endothoracic)

1

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

1

XV.b Path: Eosinophilic pneumonia (subacute or acute) (see also Ic)

1

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

1

XV.e Path: ILD with a granulomatous component (see also Im)

1

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

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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