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
Antiviral therapy/agents (direct-acting) against hepatitis C virus
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 III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) IV.d IV - Airway involvement
IV.d - Cough (lone) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) X.e X - Systemic/Distant conditions, syndromes and reactions
X.e - Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs) XI.c XI - Miscellaneous
XI.c - Pleuritic chest pain XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XVI.b XVI - Imaging
XVI.b - Imaging: Ground-glass opacities (GGO) / shadowing XVII.f XVII - Infections & related conditions
XVII.f - Tuberculosis, miliary XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes XIX.b XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.b - BAL: An excess proportion of neutrophils XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
Apalutamide
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) XVII.g XVII - Infections & related conditions
XVII.g - Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo
Apatinib
I.b - Pneumonitis (ILD) III.c III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.c - Hemoptysis III.h III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.h - Major/massive hemoptysis V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax
Apixaban
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) V.e V - Pleural and/or pericardial involvement
V.e - Hemothorax - Serosanguineous pleural effusion V.n V - Pleural and/or pericardial involvement
V.n - Hemopericardium - Bloody pericardial effusion
Aripiprazole
I.b - Pneumonitis (ILD) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) IX.f IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.f - Hiccup XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib)
Arsenic trioxide (As2O3)
I.b - Pneumonitis (ILD) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.k II - Pulmonary edema - Acute lung injury - ARDS
II.k - Pulmonary edema/ARDS of the ATRA syndrome (see Xab) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) X.r X - Systemic/Distant conditions, syndromes and reactions
X.r - Fluid retention X.ab X - Systemic/Distant conditions, syndromes and reactions
X.ab - The differentiation- or ATRA syndrome XII.c XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade) XII.ai XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity
Atenolol
I.b - Pneumonitis (ILD) 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) X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd)
Atezolizumab
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.k I - Interstitial/parenchymal lung disease
I.k - Lung nodule or nodules V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) V.i V - Pleural and/or pericardial involvement
V.i - Pleuritis (can cause chest pain) VII.e VII - Mediastinal involvement
VII.e - Granulomatous mediastinal lymphadenopathy X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) X.ae X - Systemic/Distant conditions, syndromes and reactions
X.ae - Antisynthetase antibodies (ASA) - ASA syndrome X.am X - Systemic/Distant conditions, syndromes and reactions
X.am - Immune-related adverse effect/toxicity XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XII.ai XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity XV.ba XV - Pathology
XV.ba - Path: Granulomatous lymphadenopathy
Atorvastatin
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) X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) X.s X - Systemic/Distant conditions, syndromes and reactions
X.s - Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive X.y X - Systemic/Distant conditions, syndromes and reactions
X.y - Subclinical ANA positivity
Aurothiopropanosulfonate
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.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis IV.c IV - Airway involvement
IV.c - Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib)
Avelumab
I.b - Pneumonitis (ILD) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) 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)
Axitinib
I.b - Pneumonitis (ILD) III.c III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.c - Hemoptysis V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax VIII.j VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.j - Laryngeal disorder-Laryngeal nerve palsy (dysphonia, hoarseness) XI.w XI - Miscellaneous
XI.w - Cavitation/necrosis of lung tumor or metastases XVI.bf XVI - Imaging
XVI.bf - Imaging: Tumoral cavitation
Azacitidine
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) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury V.i V - Pleural and/or pericardial involvement
V.i - Pleuritis (can cause chest pain) V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) XI.c XI - Miscellaneous
XI.c - Pleuritic chest pain XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)
Azathioprine
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.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.l I - Interstitial/parenchymal lung disease
I.l - Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component I.q I - Interstitial/parenchymal lung disease
I.q - Pulmonary nodulosis I.ah I - Interstitial/parenchymal lung disease
I.ah - Acute restrictive lung dysfunction 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) VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) 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.o X - Systemic/Distant conditions, syndromes and reactions
X.o - Neutrophilic dermatosis (Pyoderma, Sweet syndrome) XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis XIII.b XIII - Neoplastic conditions
XIII.b - Lymphoproliferative disease (pulmonary, endobronchial, endothoracic) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.j XV - Pathology
XV.j - Path: Pulmonary fibrosis (UIP-pattern) XV.bq XV - Pathology
XV.bq - Path: Lymphoproliferative disease, endothoracic XVII.e XVII - Infections & related conditions
XVII.e - Pneumocystis jiroveci pneumonia XVII.h XVII - Infections & related conditions
XVII.h - Nontuberculous pulmonary mycobacterial infection/superinfection XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes
BCG therapy (topical instillations in the urinary bladder)
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.l I - Interstitial/parenchymal lung disease
I.l - Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury IV.d IV - Airway involvement
IV.d - Cough (lone) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) VII.e VII - Mediastinal involvement
VII.e - Granulomatous mediastinal lymphadenopathy VIII.c VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.c - Upper airway obstruction other than angioedema or hematoma IX.r IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.r - Myasthenia gravis - Myasthenic-like syndrome IX.ab IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.ab - Guillain-Barré (or GB-like) syndrome (w/wo ARF) 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.l X - Systemic/Distant conditions, syndromes and reactions
X.l - Systemic granulomatosis other than Xk 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) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.ba XV - Pathology
XV.ba - Path: Granulomatous lymphadenopathy XV.cg XV - Pathology
XV.cg - Path: Granulomatous hepatitis XVI.u XVI - Imaging
XVI.u - Imaging: A miliary pattern (diffuse random micronodules) XVI.ai XVI - Imaging
XVI.ai - Imaging: A 'tree-in-bud' pattern XVII.f XVII - Infections & related conditions
XVII.f - Tuberculosis, miliary XVII.i XVII - Infections & related conditions
XVII.i - Mycobacterium bovis/BCG infection
Benzylthiouracil
I.b - Pneumonitis (ILD) III.b III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.b - Pneumorenal syndrome (w/wo ANCAs) III.d III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.d - Alveolar hemorrhage, diffuse (ANCA-positive/-related) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis X.s X - Systemic/Distant conditions, syndromes and reactions
X.s - Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive
Beta-blockers
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.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.u I - Interstitial/parenchymal lung disease
I.u - Relapsing or migrating pneumonitis/pneumonia (see also Id) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) 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) IV.ab IV - Airway involvement
IV.ab - Exacerbation or deterioration of preexisting COPD IV.ac IV - Airway involvement
IV.ac - Exacerbation or deterioration of preexisting 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.d V - Pleural and/or pericardial involvement
V.d - Pleural/pericardial effusion, ANA positive (DI lupus) VI.w VI - Pulmonary vasculopathies
VI.w - Worsening of preexisting PHTn IX.d IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.d - Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis) 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.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XI.af XI - Miscellaneous
XI.af - Refractoriness to epineprine in case of anaphylaxis XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac- cardiorespiratory/pulmonary arrest XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension XII.af XII - Cardiovascular involvement / toxicity
XII.af - Coronary vasospasm - Vasospastic angina