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
Leflunomide
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.l I - Interstitial/parenchymal lung disease
I.l - Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf) I.n I - Interstitial/parenchymal lung disease
I.n - Pulmonary alveolar proteinosis (PAP) I.q I - Interstitial/parenchymal lung disease
I.q - Pulmonary nodulosis I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis I.z I - Interstitial/parenchymal lung disease
I.z - An area or areas of consolidation IV.d IV - Airway involvement
IV.d - Cough (lone) 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 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) 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.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.i XV - Pathology
XV.i - Path: Pneumocyte atypia (reactive epithelial cells) (a.k.a. the "Napoleon Hat" sign) XVII.g XVII - Infections & related conditions
XVII.g - Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes
Lenalidomide
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.h I - Interstitial/parenchymal lung disease
I.h - Subclinical pulmonary infiltrates/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) VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.n X - Systemic/Distant conditions, syndromes and reactions
X.n - Tumor lysis syndrome (TLS) XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XVII.j XVII - Infections & related conditions
XVII.j - Mucormycosis (pulmonary, tracheobronchial or systemic) 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
Lenvatinib
I.b - Pneumonitis (ILD) V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism XVI.ab XVI - Imaging
XVI.ab - Imaging: Cavitating/cavitary lung nodule, mass or nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)
Leuprorelin - Leuprolide
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 V.e V - Pleural and/or pericardial involvement
V.e - Hemothorax - Serosanguineous pleural effusion X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.j X - Systemic/Distant conditions, syndromes and reactions
X.j - Myopathy-Myositis-Polymyositis (see also under Xba)
Levetiracetam
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) 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)
Levofloxacin
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) IX.g IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.g - Hyperpnea - Hyperventilation - Low PaCO2 X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal)
Lisuride
I.b - Pneumonitis (ILD) V.c V - Pleural and/or pericardial involvement
V.c - Pleural thickening XII.b XII - Cardiovascular involvement / toxicity
XII.b - Valvular heart disease and/or dysfunction XII.af XII - Cardiovascular involvement / toxicity
XII.af - Coronary vasospasm - Vasospastic angina
Lorlatinib
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) 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 VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension IX.r IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.r - Myasthenia gravis - Myasthenic-like syndrome
Loxoprofen
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) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma XII.ay XII - Cardiovascular involvement / toxicity
XII.ay - Coronary (artery) vasculitis XII.bj XII - Cardiovascular involvement / toxicity
XII.bj - Eosinophilic coronary (peri)-arteritis XV.cm XV - Pathology
XV.cm - Path: Coronary vasculitis w/wo eosinophilia
MTOR inhibitors
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.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) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) XI.w XI - Miscellaneous
XI.w - Cavitation/necrosis of lung tumor or metastases XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XVI.bf XVI - Imaging
XVI.bf - Imaging: Tumoral cavitation XVII.a XVII - Infections & related conditions
XVII.a - Respiratory tract infection incl. pneumonia
Mefloquine
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) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury
Mercury fumes/vapor
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.w I - Interstitial/parenchymal lung disease
I.w - Rapidly progressive ILD/pulmonary fibrosis (Hamman-Rich syndrome) I.af I - Interstitial/parenchymal lung disease
I.af - Chemical (toxic) 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 IV.t IV - Airway involvement
IV.t - Sptutum production - Bronchorrhea - 'Bronchitis' XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP) XII.ah XII - Cardiovascular involvement / toxicity
XII.ah - Tachycardia XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.h XV - Pathology
XV.h - Path: NSIP-fibrotic pattern
Mesalazine-Mesalamine-5-aminosalicylic acid-5-ASA
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.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component II.d II - Pulmonary edema - Acute lung injury - ARDS
II.d - Pulmonary edema, cardiogenic IV.c IV - Airway involvement
IV.c - Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx) IV.j IV - Airway involvement
IV.j - Bronchiolitis (a clinical-imaging pattern suggestive of) IV.k IV - Airway involvement
IV.k - Bronchiectasis IV.ad IV - Airway involvement
IV.ad - Large airway inflammation - Tracheitis (w/wo tissue eosinophilia) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) 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) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure XII.c XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade) XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XII.g XII - Cardiovascular involvement / toxicity
XII.g - Coronary artery disease (acute) - Myocardial ischemia/infarction XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension XII.q XII - Cardiovascular involvement / toxicity
XII.q - Pericarditis (see also under XIIc) XII.bf XII - Cardiovascular involvement / toxicity
XII.bf - Myopericarditis (see under XIIc/d/g) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) XV.z XV - Pathology
XV.z - Path: Obliterative (constrictive) bronchiolitis (see also IVc, IVn) XVI.b XVI - Imaging
XVI.b - Imaging: Ground-glass opacities (GGO) / shadowing XVI.k XVI - Imaging
XVI.k - Imaging: An area or areas of consolidation XVI.ay XVI - Imaging
XVI.ay - Imaging: Asymmetrical, predominantly unilateral involvement 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
Methotrexate
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.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.h I - Interstitial/parenchymal lung disease
I.h - Subclinical pulmonary infiltrates/ILD 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 I.q I - Interstitial/parenchymal lung disease
I.q - Pulmonary nodulosis 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.aa I - Interstitial/parenchymal lung disease
I.aa - Delayed ILD, -pneumonitis, -fibrosis 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 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 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) V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion V.e V - Pleural and/or pericardial involvement
V.e - Hemothorax - Serosanguineous pleural effusion V.i V - Pleural and/or pericardial involvement
V.i - Pleuritis (can cause chest pain) V.n V - Pleural and/or pericardial involvement
V.n - Hemopericardium - Bloody pericardial effusion V.s V - Pleural and/or pericardial involvement
V.s - Serositis - Polyserositis VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism 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) VIII.aj VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.aj - Endobronchial lymphoproliferative disorder 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.u X - Systemic/Distant conditions, syndromes and reactions
X.u - Multiple organ dysfunction/failure (MODS/MOF) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XI.c XI - Miscellaneous
XI.c - Pleuritic chest pain XII.c XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade) XIII.b XIII - Neoplastic conditions
XIII.b - Lymphoproliferative disease (pulmonary, endobronchial, endothoracic) XIII.g XIII - Neoplastic conditions
XIII.g - Lymphomatoid granulomatosis (pulmonary, endothoracic) XIII.k XIII - Neoplastic conditions
XIII.k - Lymphoproliferative disease (extrathoracic) 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.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.h XV - Pathology
XV.h - Path: NSIP-fibrotic pattern XV.i XV - Pathology
XV.i - Path: Pneumocyte atypia (reactive epithelial cells) (a.k.a. the "Napoleon Hat" sign) XV.w XV - Pathology
XV.w - Path: Pulmonary edema (see also II/IIa) XV.bq XV - Pathology
XV.bq - Path: Lymphoproliferative disease, endothoracic XVI.b XVI - Imaging
XVI.b - Imaging: Ground-glass opacities (GGO) / shadowing XVI.k XVI - Imaging
XVI.k - Imaging: An area or areas of consolidation XVI.w XVI - Imaging
XVI.w - Imaging: Lung nodule or nodules XVI.bc XVI - Imaging
XVI.bc - Imaging: Intrathoracic lymph node enlargement XVII.b XVII - Infections & related conditions
XVII.b - Opportunistic pulmonary/systemic infections XVII.d XVII - Infections & related conditions
XVII.d - Pneumocystis jiroveci pulmonary colonization XVII.e XVII - Infections & related conditions
XVII.e - Pneumocystis jiroveci pneumonia XVII.h XVII - Infections & related conditions
XVII.h - Nontuberculous pulmonary mycobacterial infection/superinfection XVII.q XVII - Infections & related conditions
XVII.q - Viral pneumonia 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