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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Leflunomide

3

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

1
Last update : 19/08/2013
 
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Identify causative drugs
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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Publications

Leflunomide-induced interstitial pneumonitis might be a representative of disease-modifying antirheumatic drug-induced lung injury.
Expert opinion on drug safety 2011 Jul;10;603-11 2011 Jul
Factors associated with fatal outcome of leflunomide-induced lung injury in Japanese patients with rheumatoid arthritis.
Rheumatology (Oxford, England) 2009 Oct;48;1265-8 2009 Oct
Leflunomide-induced pneumonitis in a patient with rheumatoid arthritis.
Internal medicine (Tokyo, Japan) 2006;45;689-91 2006
Leflunomide-related acute interstitial pneumonia in two patients with rheumatoid arthritis: autopsy findings with a mosaic pattern of acute and organizing diffuse alveolar damage.
Modern rheumatology 2006;16;316-20 2006

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