I.b
Pneumonitis (ILD)
Or 'ILD'. (Fr: PnP subaiguë). A.k.a. pulmonary infiltrates. Generally bilateral and symmetrical. Gradual onset. Consistent with but not specific for an NSIP-c pattern on pathology. Less- dense, severe, acute and diffuse than pattern Ia. Lacks the features of ARDS that may accompany pattern Ia. Can be in the form of disseminated linear, reticulonodular, miliary or patchy opacities. BAL is indicated to separate this pattern from PIE (Ic) or DAH (IIIa). Acute chest pain can be at the forefront. A search for microorganisms including Pneumocystis (stains, PCR) is indicated. On pathology (although not many cases undergo a confirmatory lung biopsy), there is interstitial inflammation and a more or less dense cellular interstitial cellular infiltrate (NSIP-c). Fibrosis, alveolar edema and/or a reactive epithelium denote those cases resulting from with antineoplastic chemotherapy agents. The frontier between patterns Ia and I b can be difficult to draw, so please check drugs under both Ia and Ib. Patients may quickly shift from pattern Ib to Ia particularly if the the causal drug is inappropriately continued. Prompt withdrawal must be considered, underlying disease permitting, and can be therapeutic.
Causative drugs
Penicillins
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.f IV - Airway involvement
IV.f - Severe or catastrophic bronchospasm or asthma attack (can be fatal) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.h X - Systemic/Distant conditions, syndromes and reactions
X.h - Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) X.t X - Systemic/Distant conditions, syndromes and reactions
X.t - Jarisch-Herxheimer reaction
Perindopril
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component IV.d IV - Airway involvement
IV.d - Cough (lone) V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) VIII.q VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.q - Tongue involvement (edema, glossitis, hematoma) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im)
Phenytoin (diphenylhydantoin)
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.k I - Interstitial/parenchymal lung disease
I.k - Lung nodule or nodules II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) III.b III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.b - Pneumorenal syndrome (w/wo ANCAs) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.d IV - Airway involvement
IV.d - Cough (lone) IV.n IV - Airway involvement
IV.n - Obstructive airway dysfunction (see also IVc, XVx) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) VII.b VII - Mediastinal involvement
VII.b - Lymphadenopathy with reactive changes VII.m VII - Mediastinal involvement
VII.m - Malignant lymphoma X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) X.h X - Systemic/Distant conditions, syndromes and reactions
X.h - Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) X.u X - Systemic/Distant conditions, syndromes and reactions
X.u - Multiple organ dysfunction/failure (MODS/MOF) XI.ab XI - Miscellaneous
XI.ab - Gingival hypertrophy XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac- cardiorespiratory/pulmonary arrest XII.x XII - Cardiovascular involvement / toxicity
XII.x - Sinus arrest XII.as XII - Cardiovascular involvement / toxicity
XII.as - Giant cell myocarditis XIII.b XIII - Neoplastic conditions
XIII.b - Lymphoproliferative disease (pulmonary, endobronchial, endothoracic) XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XV.m XV - Pathology
XV.m - Path: Lymphoid hyperplasia (including nodular- or a lymphocytic interstitial pneumonia pattern) XV.ab XV - Pathology
XV.ab - Path: Pulmonary capillaritis XV.ac XV - Pathology
XV.ac - Path: Pulmonary vasculitis other than capillaritis XV.af XV - Pathology
XV.af - Path: Granulomatous pulmonary vasculitis XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes
Pioglitazone
I.b - Pneumonitis (ILD) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.d II - Pulmonary edema - Acute lung injury - ARDS
II.d - Pulmonary edema, cardiogenic V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic)
Piperacilline
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.aa IV - Airway involvement
IV.aa - Occupational asthma VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement)
Pirfenidone
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) XV.ba XV - Pathology
XV.ba - Path: Granulomatous lymphadenopathy XVII.g XVII - Infections & related conditions
XVII.g - Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo
Pituitary snuff
I.b - Pneumonitis (ILD) I.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.an I - Interstitial/parenchymal lung disease
I.an - Hypersensitivity pneumonitis pattern IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma
Pomalidomide
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis XVII.a XVII - Infections & related conditions
XVII.a - Respiratory tract infection incl. pneumonia XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
Ponatinib
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure XII.g XII - Cardiovascular involvement / toxicity
XII.g - Coronary artery disease (acute) - Myocardial ischemia/infarction
Practolol
I.b - Pneumonitis (ILD) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) V.c V - Pleural and/or pericardial involvement
V.c - Pleural thickening V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) XII.k XII - Cardiovascular involvement / toxicity
XII.k - Constrictive pericarditis - Pericardial thickening
Pranlukast
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) X.h X - Systemic/Distant conditions, syndromes and reactions
X.h - Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic) XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis
Pravastatin
I.b - Pneumonitis (ILD) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) X.j X - Systemic/Distant conditions, syndromes and reactions
X.j - Myopathy-Myositis-Polymyositis (see also under Xba) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent
Pregabalin
I.b - Pneumonitis (ILD) VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) IX.d IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.d - Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis) IX.p IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.p - Disordered breathing during sleep - Sleep apnea IX.v IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.v - Generalized myopathy/muscle weakness X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XII.s XII - Cardiovascular involvement / toxicity
XII.s - Heart block (bundle branch- or AV-)
Procainamide
I.b - Pneumonitis (ILD) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) V.c V - Pleural and/or pericardial involvement
V.c - Pleural thickening V.d V - Pleural and/or pericardial involvement
V.d - Pleural/pericardial effusion, ANA positive (DI lupus) V.i V - Pleural and/or pericardial involvement
V.i - Pleuritis (can cause chest pain) VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism X.b X - Systemic/Distant conditions, syndromes and reactions
X.b - Antiphospholipid antibodies w/wo the APL syndrome X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) X.y X - Systemic/Distant conditions, syndromes and reactions
X.y - Subclinical ANA positivity XI.n XI - Miscellaneous
XI.n - Neutropenia, agranulocytosis (w/wo infection/sepsis) XII.c XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade) XII.k XII - Cardiovascular involvement / toxicity
XII.k - Constrictive pericarditis - Pericardial thickening XII.p XII - Cardiovascular involvement / toxicity
XII.p - QTc prolongation
Procarbazine
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.h I - Interstitial/parenchymal lung disease
I.h - Subclinical pulmonary infiltrates/ILD V.i V - Pleural and/or pericardial involvement
V.i - Pleuritis (can cause chest pain) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im)
Propoxyphene
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure
Propranolol
I.b - Pneumonitis (ILD) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.d II - Pulmonary edema - Acute lung injury - ARDS
II.d - Pulmonary edema, cardiogenic IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.f IV - Airway involvement
IV.f - Severe or catastrophic bronchospasm or asthma attack (can be fatal) VIII.e VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.e - Laryngospasm (a.k.a. laryngismus) IX.i IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.i - Respiratory arrest - Apnea X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XI.af XI - Miscellaneous
XI.af - Refractoriness to epineprine in case of anaphylaxis XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension XII.p XII - Cardiovascular involvement / toxicity
XII.p - QTc prolongation