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
Lamotrigine
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.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.ag IV - Airway involvement
IV.ag - Bronchocentric granulomatosis 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.az X - Systemic/Distant conditions, syndromes and reactions
X.az - Hemophagocytic syndrome XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis XII.s XII - Cardiovascular involvement / toxicity
XII.s - Heart block (bundle branch- or AV-) XV.cc XV - Pathology
XV.cc - Path: Eosinophilic myocarditis XV.cu XV - Pathology
XV.cu - Path: Bronchocentric granulomatosis XXIV.g XXIV - Veterinary medicine
XXIV.g - Veterinary: Cardiac arrhythmias
Laninamivir
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
Lansoprazole
I.b - Pneumonitis (ILD) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.v IV - Airway involvement
IV.v - Deterioration/exacerbation of preexisting asthma or COPD XVII.a XVII - Infections & related conditions
XVII.a - Respiratory tract infection incl. pneumonia
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