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
Everolimus
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) I.h I - Interstitial/parenchymal lung disease
I.h - Subclinical pulmonary infiltrates/ILD 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.p I - Interstitial/parenchymal lung disease
I.p - Fatal pneumonitis (ILD) I.v I - Interstitial/parenchymal lung disease
I.v - Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis I.ad I - Interstitial/parenchymal lung disease
I.ad - Radiation recall pneumonitis 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.h III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.h - Major/massive hemoptysis IV.d IV - Airway involvement
IV.d - Cough (lone) V.h V - Pleural and/or pericardial involvement
V.h - Chylothorax 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 VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.d XV - Pathology
XV.d - Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also If) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XVI.b XVI - Imaging
XVI.b - Imaging: Ground-glass opacities (GGO) / shadowing XVI.bl XVI - Imaging
XVI.bl - Imaging: An area or areas of avid tracer uptake in the lung/chest on 18F-PET scan XVII.e XVII - Infections & related conditions
XVII.e - Pneumocystis jiroveci pneumonia
FOLFOX chemotherapy regimen
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.v I - Interstitial/parenchymal lung disease
I.v - Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence I.w I - Interstitial/parenchymal lung disease
I.w - Rapidly progressive ILD/pulmonary fibrosis (Hamman-Rich syndrome) I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis I.bb I - Interstitial/parenchymal lung disease
I.bb - Fatal pulmonary fibrosis 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.c VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.c - Upper airway obstruction other than angioedema or hematoma X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL)
Fingolimod
I.b - Pneumonitis (ILD) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.d IV - Airway involvement
IV.d - Cough (lone) IV.f IV - Airway involvement
IV.f - Severe or catastrophic bronchospasm or asthma attack (can be fatal) XII.s XII - Cardiovascular involvement / toxicity
XII.s - Heart block (bundle branch- or AV-) XII.ag XII - Cardiovascular involvement / toxicity
XII.ag - Bradycardia XVII.a XVII - Infections & related conditions
XVII.a - Respiratory tract infection incl. pneumonia XVII.b XVII - Infections & related conditions
XVII.b - Opportunistic pulmonary/systemic infections XVII.q XVII - Infections & related conditions
XVII.q - Viral pneumonia
Flavocoxid
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 VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death)
Flecainide
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 IX.h IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.h - Dyspnea, unexplained otherwise XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension XII.s XII - Cardiovascular involvement / toxicity
XII.s - Heart block (bundle branch- or AV-) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.d XV - Pathology
XV.d - Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also If) XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XV.j XV - Pathology
XV.j - Path: Pulmonary fibrosis (UIP-pattern) 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
Fludarabine
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.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) I.k I - Interstitial/parenchymal lung disease
I.k - Lung nodule or nodules 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 III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) V.i V - Pleural and/or pericardial involvement
V.i - Pleuritis (can cause chest pain) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.d XV - Pathology
XV.d - Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also If) XVII.b XVII - Infections & related conditions
XVII.b - Opportunistic pulmonary/systemic infections XVII.e XVII - Infections & related conditions
XVII.e - Pneumocystis jiroveci pneumonia XVII.w XVII - Infections & related conditions
XVII.w - Hypogammaglobulinemia - Antibody deficiency
Fluoxetine
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.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.k I - Interstitial/parenchymal lung disease
I.k - Lung nodule or nodules I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis 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.ac XV - Pathology
XV.ac - Path: Pulmonary vasculitis other than capillaritis
Furazolidone
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) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent
G/GM-CSF
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) 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.f II - Pulmonary edema - Acute lung injury - ARDS
II.f - Hypoxemia, low oxygen saturation (may occur in isolation) IV.f IV - Airway involvement
IV.f - Severe or catastrophic bronchospasm or asthma attack (can be fatal) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism VI.e VI - Pulmonary vasculopathies
VI.e - Fat/oil embolism - The FES embolism syndrome X.c X - Systemic/Distant conditions, syndromes and reactions
X.c - Capillary leak syndrome (CLS) X.o X - Systemic/Distant conditions, syndromes and reactions
X.o - Neutrophilic dermatosis (Pyoderma, Sweet syndrome) X.ao X - Systemic/Distant conditions, syndromes and reactions
X.ao - Flare of preexisting vasculitis XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis XII.at XII - Cardiovascular involvement / toxicity
XII.at - Aortitis XIX.b XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.b - BAL: An excess proportion of neutrophils
Gastric banding
I.b - Pneumonitis (ILD) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) 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 IV.k IV - Airway involvement
IV.k - Bronchiectasis VIII.c VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.c - Upper airway obstruction other than angioedema or hematoma X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) XI.g XI - Miscellaneous
XI.g - Aspiration, aspiration pneumonia (w/wo demonstrable pharyngeal dysmotility) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XVII.a XVII - Infections & related conditions
XVII.a - Respiratory tract infection incl. pneumonia XVII.p XVII - Infections & related conditions
XVII.p - Lung abscess/abscesses (see also VIr)
Gefitinib
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) 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) 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) V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax V.ab V - Pleural and/or pericardial involvement
V.ab - Pneumothorax, bilateral XI.w XI - Miscellaneous
XI.w - Cavitation/necrosis of lung tumor or metastases XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XII.ax XII - Cardiovascular involvement / toxicity
XII.ax - Necrotizing myocarditis (w/o evidence for CAD) 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.ce XV - Pathology
XV.ce - Path: Necrotizing myocarditis XVI.b XVI - Imaging
XVI.b - Imaging: Ground-glass opacities (GGO) / shadowing XVI.af XVI - Imaging
XVI.af - Imaging: Lung cysts or bullae (see also XVI ah/bf) XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
Gemcitabine
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.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.h I - Interstitial/parenchymal lung disease
I.h - Subclinical pulmonary infiltrates/ILD I.l I - Interstitial/parenchymal lung disease
I.l - Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf) I.ad I - Interstitial/parenchymal lung disease
I.ad - Radiation recall pneumonitis 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.c II - Pulmonary edema - Acute lung injury - ARDS
II.c - ARDS and the hemolytic-uremic syndrome (HUS) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) III.h III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.h - Major/massive hemoptysis IV.b IV - Airway involvement
IV.b - Bronchospasm and angioedema 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) V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension VI.c VI - Pulmonary vasculopathies
VI.c - Pulmonary veno-occlusive disease VI.f VI - Pulmonary vasculopathies
VI.f - Hemolytic and uremic syndrome (HUS). See also under Xaf X.c X - Systemic/Distant conditions, syndromes and reactions
X.c - Capillary leak syndrome (CLS) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) X.n X - Systemic/Distant conditions, syndromes and reactions
X.n - Tumor lysis syndrome (TLS) X.af X - Systemic/Distant conditions, syndromes and reactions
X.af - Thrombotic microangiopathy XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XII.c XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade) XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic) 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.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XVI.b XVI - Imaging
XVI.b - Imaging: Ground-glass opacities (GGO) / shadowing XVI.n XVI - Imaging
XVI.n - Imaging: Intralobular septal thickening - Crazy paving XVII.e XVII - Infections & related conditions
XVII.e - Pneumocystis jiroveci pneumonia
Gold (chrysotherapy)
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.h I - Interstitial/parenchymal lung disease
I.h - Subclinical pulmonary infiltrates/ILD IV.c IV - Airway involvement
IV.c - Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx) IV.n IV - Airway involvement
IV.n - Obstructive airway dysfunction (see also IVc, XVx) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes
Golimumab
I.b - Pneumonitis (ILD) 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 XVII.g XVII - Infections & related conditions
XVII.g - Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo
Guselkumab
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) X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XVII.g XVII - Infections & related conditions
XVII.g - Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo
Hash oil (Butane hash oil - BHO) - Dabbing
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma VIII.d VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.d - Thermal (burns, frostbite), chemical or caustic injury on the face, mouth, tongue, pharynx or upper airway XVI.b XVI - Imaging
XVI.b - Imaging: Ground-glass opacities (GGO) / shadowing XVI.c XVI - Imaging
XVI.c - Imaging: A mosaic pattern of attenuation