Drug-induced lung disease

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Drug-induced lung disease can result from a number of agents and ~~can~~may have a myriad of presentations, ranging from an adult respiratory distress syndrome type picture to established pulmonary fibrosis.

Due to this, it can be extremely difficult to pinpoint the offending agent on imaging appearances alone and correlation with the medical history is mandatory.

Pathology

Aetiology

Chemotherapy agents

These can give several patterns of disease which include ^1,5:

interstitial fibrosis: typically NSIP ⁵ pattern
hypersensitivity pneumonitis pattern
adult respiratory distress syndrome / diffuse alveolar damage pattern
bronchiolitis obliterans organising pneumonia type pattern
pulmonary haemorrhage

Example agents include:

Immunosuppressive agents

sirolimus: sirolimus-associated pulmonary toxicity⁹
leflunomide (arava): leflunomide ~~induced~~-induced acute interstitial pneumonia ¹⁰
sulfasalazine lung toxicity

Immunotherapy agents

Immune-mediated pneumonitis usually happens between 8 to 14 weeks after the start of treatment ¹³. Examples of agents include:

nivolumab
pembrolizumab
ipilimumab

Cardiovascular agents

amiodarone lung toxicity

Antibiotic agents

Can also ~~the~~ give similar patterns to that of chemotherapeutic agents. ~~Examples~~ Examples include:

Others

Accidental ~~or unintended~~ inhalation or ingestion of various agents:

herbicides
- paraquat (N,N′-dimethyl-4,4′-bipyridinium dichloride): paraquat-induced lung disease

-<p><strong>Drug-induced lung disease</strong> can result from a number of agents and can have a myriad of presentations, ranging from <a href="/articles/acute-respiratory-distress-syndrome-1">adult respiratory distress syndrome</a> type picture to established <a href="/articles/pulmonary-fibrosis">pulmonary fibrosis</a>.</p><p>Due to this, it can be extremely difficult to pinpoint the offending agent on imaging appearances alone and correlation with the medical history is mandatory. </p><h4>Pathology</h4><h5>Aetiology</h5><h6>Chemotherapy agents</h6><p>These can give several patterns of disease which include <sup>1,5 </sup>:</p><ul>
+<p><strong>Drug-induced lung disease</strong> can result from a number of agents and may have a myriad of presentations, ranging from an <a href="/articles/acute-respiratory-distress-syndrome-1">adult respiratory distress syndrome</a> type picture to established <a href="/articles/pulmonary-fibrosis">pulmonary fibrosis</a>.</p><p>Due to this, it can be extremely difficult to pinpoint the offending agent on imaging appearances alone and correlation with the medical history is mandatory. </p><h4>Pathology</h4><h5>Aetiology</h5><h6>Chemotherapy agents</h6><p>These can give several patterns of disease which include <sup>1,5 </sup>:</p><ul>
~~-<a href="/articles/docitaxel-induced-interstitial-pneumonitis">docitaxel induced interstitial pneumonitis</a><sup> 11,12</sup>~~
+<a href="/articles/docitaxel-induced-interstitial-pneumonitis">docetaxel induced interstitial pneumonitis</a><sup> 11,12</sup>
~~-<li>leflunomide (arava): <a href="/articles/leflunomide-induced-acute-interstitial-pneumonia">leflunomide induced acute interstitial pneumonia</a> <sup>10</sup>~~
+<li>leflunomide (arava): <a href="/articles/leflunomide-induced-acute-interstitial-pneumonia">leflunomide-induced acute interstitial pneumonia</a> <sup>10</sup>
-<a href="/articles/amiodarone-lung-1">amiodarone lung</a> toxicity</li></ul><h6>Antibiotic agents</h6><p>Can also the give similar patterns to that of chemotherapeutic agents. Examples include:</p><ul>
+<a href="/articles/amiodarone-lung-1">amiodarone lung</a> toxicity</li></ul><h6>Antibiotic agents</h6><p>Can also give similar patterns to that of chemotherapeutic agents. <br>Examples include:</p><ul>
-<li>IV heroin <sup>6</sup>: <a href="/articles/pulmonary-oedema">pulmonary oedema</a>, <a href="/articles/pulmonary-haemorrhage">pulmonary haemorrhage</a>, <a href="/articles/eosinophillic-pneumonia">eosinophillic pneumonia</a>
+<li>IV heroin <sup>6</sup>: <a href="/articles/pulmonary-oedema">pulmonary oedema</a>, <a href="/articles/pulmonary-haemorrhage">pulmonary haemorrhage</a>, <a href="/articles/eosinophillic-pneumonia">eosinophilic pneumonia</a>
-</li></ul><h6>Others</h6><p>Accidental or unintended inhalation or ingestion of various agents:</p><ul><li>herbicides<ul><li>paraquat (N,N′-dimethyl-4,4′-bipyridinium dichloride): <a href="/articles/paraquat-induced-lung-disease-1">paraquat-induced lung disease</a>
+</li></ul><h6>Others</h6><p>Accidental inhalation or ingestion of various agents:</p><ul><li>herbicides<ul><li>paraquat (N,N′-dimethyl-4,4′-bipyridinium dichloride): <a href="/articles/paraquat-induced-lung-disease-1">paraquat-induced lung disease</a>

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