Drug-induced lung disease

Drug-induced lung disease can result from a number of agents and 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

Etiology
Chemotherapy agents

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

Example agents include:

Immunosuppressive agents
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
Antibiotic agents

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

Anti-inflammatory agents
Recreational drugs
Anticonvulsants
Others

Accidental inhalation or ingestion of various agents:

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Article information

rID: 10797
System: Chest
Section: Gamuts
Synonyms or Alternate Spellings:
  • Toxic pneumonitis
  • Drug induced lung disease
  • Drug induced interstitial lung disease
  • Drug induced pulmonary disease
  • Drug-induced lung injury
  • Drug induced interstitial pulmonary disease

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Cases and figures

  • 3 months after in...
    Case 1: interstitial fibrosis from ABVD chemotherapy
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  • Case 2: amiodarone lung
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  • Case 3: Rituximab-induced interstitial lung disease
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  • Case 4: immunotherapy-induced pneumonitis
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  • Case 5: probable gemcitabine lung toxicity
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