Hypersensitivity Pneumonitis Acute to subacute presentation with systemic symptoms fever, fatigue, arthralgia – dyspnea and cough may be late Eosinophilia may be present Radiographs show air space disease 23. [slideshare.net]

Microscopic (histologic) description Intra-alveolar exudate of finely vacuolated foamy macrophages, also present within alveolar septa May have diffuse alveolar damage, cryptogenic organizing pneumonia type changes or changes of nonspecific interstitial [pathologyoutlines.com]

LEFT: HRCT at presentation. RIGHT: HRCT ten days later This patient presented with acute dyspnoe and a normal chest film (not shown). The HRCT at presentation (left) shows lobular areas of ground glass attenuation. [radiologyassistant.nl]

• Hypoxemia

  Occurs more with higher doses of drugs Chronic pulmonary fibrosis Drugs that cause pulmonary fibrosis Bleomycin Busulfan Carmustine Methotrexate Amiodarone Non-productive cough Acute dyspnea Tachypnea Lung crackles PFTs initially normal then reduce CO2 hypoxemia [brainscape.com]

  Patients usually present with hemoptysis, dyspnea, and hypoxemia. Diffuse alveolar hemorrhage is characterized by bilateral infiltrates in the context of anemia of recent onset and hypoxemia. [emedicine.medscape.com]

  Dyspnea, cough, hypoxemia, and pulmonary infiltrates usually develop 1 week to 3 months after treatment. [10], [11], [12] Hypersensitivity reactions are well-recognized complications ofpaclitaxel therapy and typically occur with the first or second dose [ccij-online.org]

  Possible Complications Complications that may develop include: Diffuse interstitial pulmonary fibrosis Hypoxemia (low blood oxygen) Respiratory failure When to Contact a Medical Professional Call your provider if you develop symptoms of this disorder. [ufhealth.org]

  Severe cases can exhibit diffuse rales, hypoxemia and respiratory distress. The most dramatic presentation is similar to Acute Respiratory Distress Syndrome (ARDS). [jtd.amegroups.com]

• Congestive Heart Failure

  If dyspnea and/or pleuritic chest pain develop, the prudent clinician will order X-rays to rule out congestive heart failure, infectious disease, or malignancy. 3,4 Drugs and biologics can cause different types of damage: bronchiolitis obliterans organizing [pharmacytimes.com]

  A positive gallium scan result is seen in almost all patients with amiodarone pneumonitis and can help to differentiate it from pulmonary embolism and congestive heart failure. [emedicine.medscape.com]

• Dyspnea

  Paclitaxel Pulmonary ToxicitySyndromes Dyspnea during infusion – common Hypersensitivity pneumonitis –  Subacute development of dyspnea  CT scans show transient ground glass infiltrate or interstitial infiltrates  Usually resolves spontaneously or [slideshare.net]

  The symptoms of the disease include dyspnea, non-productive cough, fever and damage to the lung cells. It is diagnosed with the aid of chest radiography, high resolution computed tomographic scanning and the result of pulmonary function tests. [ncbi.nlm.nih.gov]

  Patients who have developed amiodarone-induced lung toxicity usually present with nonspecific symptoms such as cough, dyspnea, fever, and weight loss. [emedicine.medscape.com]

  Dyspnea is the most frequent respiratory side-effect reported. In a recent randomized study dyspnea was severe in 13% of cases [ 117 ]. [annonc.oxfordjournals.org]

• Sputum

  […] acute reaction, but can slowly damage various parts of the lung Some antibiotics, heart medications, and chemotherapeutic drugs are known to be damaging for the lungs The common signs and symptoms of Drug-Induced Lung Disease are cough with blood and sputum [dovemed.com]

  These include: Antibiotics, such as nitrofurantoin and sulfa drugs Heart medicines, such as amiodarone Chemotherapy drugs such as bleomycin, cyclophosphamide, and methotrexate Street drugs Symptoms Symptoms may include any of the following: Bloody sputum [ufhealth.org]

  Repeated blood and sputum cultures for bacterial, fungal and viral studies were negative. [nature.com]

  […] cultures (if sputum is produced) that are negative for pathogenic organisms Minor criteria are as follows: Nonproductive cough Shortness of breath for less than 8 weeks Oxygen saturation up to 90% on room air at the time of initial evaluation DLCO up [emedicine.medscape.com]

  Other non-invasive studies that may be helpful include an echocardiogram, sputum Gram stain and culture, and immunologic studies excluding vasculitis and connective tissue diseases. [benthamopen.com]

• Pulmonary Disorder

  Drug-induced pulmonary disorders. Semin Roentgenol 1995;30:18-34. 19. Rosenow EC, Myers JL, Swensen SJ, Pisani RJ. Drug-induced pulmonary disease:an update. Chest 1992;102:239-250. 20. Wolff AJ, O'Donnell AE. Pulmonary effects of illicit drug use. [ispub.com]

  Drug-induced pulmonary disorders Semin Roentgenol 1995; 30: 18-34. ]. Cardiovascular Agents Amiodarone is the most common drug related to cardiovascular pulmonary abnormalities. [benthamopen.com]

  Several drugs cause pulmonary vasculitis, including nitrofurantoin, sulfonamides, penicillins, phenytoin, and propylthiouracil. This disorder is likely a form of hypersensitivity pneumonitis. [emedicine.medscape.com]

• Tachypnea

  […] when do patients with narcotic induced non-cardiogenic pulmonary edema 24-48 hours but PF abnormality may last up to 12 weeks Tx for narcotic induced non-cardiogenic pulmonary edema naloxone oxygen ventilatory support Presents with Persistent cough Tachypnea [brainscape.com]

  Clinically, acute NCPE (ie, acute pulmonary edema with no evidence for left ventricular dysfunction or overload) manifests as an acute onset of dyspnea with tachypnea, tachycardia, hypoxemia, and diffuse crackles on physical examination. [emedicine.medscape.com]

• Pleuritic Pain

  pain, pleural thickening Nitrofurantoin Interstitial pneumonitis, pulmonary fibrosis, hypersensitivity lung reactions, pleural effusion, bronchospasm Infliximab Respiratory tract infection, pulmonary oedema, bronchospasm, pleurisy, pleural effusion, [resourcepharm.com]

• Nausea

  J Postgrad Med 2005;51:76-7 Sir, Hydroxyurea is a drug mainly used for the treatment of chronic myeloid leukaemia and polycythaemia. [1], [2] Its most common toxic effects are myelosuppression, nausea and skin reactions. [jpgmonline.com]

• Flushing

  Facial flushing, angioedema, and gastrointestinal symptoms can also occur. The Samter triad (or aspirin sensitive asthma, aspirin exacerbated respiratory disease [AERD]) is asthma, nasal polyps, and aspirin sensitivity. [emedicine.medscape.com]

[…] often needed to make a diagnosis, with pertinent information and expertise contributed by the pulmonologist, radiologist and pathologist. 4 High-resolution CT should be obtained in virtually all patients with a suspected ILD. 4 Additional diagnostic workup [appliedradiology.com]

At present, there is no consensus for a definite diagnostic workup approach in patients with a suspicion of diffuse DILD. [benthamopen.com]

• Pulmonary Infiltrate

  Home > Pre-Reg Pharmacist > Drug Induced Lung Disease The table below lists some drugs known to cause drug induced lung disease Drug Pulmonary Syndromes Amiodarone Interstitial pneumonitis or pulmonary fibrosis, pleural effusions, pulmonary infiltrate [resourcepharm.com]

  With Toxic Pulmonary Effects ). [msdmanuals.com]

  Pulmonary infiltrates following administration of paclitaxel. Chest 1996;110:289-92. [Figure 1], [Figure 2] [ccij-online.org]

  Conclusion This case illustrates the importance of diligence in sifting through differential diagnoses of pulmonary infiltrates. [omicsonline.org]

• Chest X-Ray Abnormal

  x-ray abnormalities, and clinical suspicion of pulmonary toxicity. [consultant360.com]

• X-Ray Abnormal

  […] develop toxicity ( Table 2 ). 9,11,14,18,21 Management Pulmonary function tests, including DLCO, are recommended at baseline and for unexplained cough or dyspnea anytime during therapy—especially in patients with underlying lung disease, suggestive chest x-ray [consultant360.com]

• Hypoalbuminemia

  Risk factors for MTX-induced lung toxicity include the following: Age older than 60 years Rheumatoid pleuropulmonary involvement Previous use of disease-modifying antirheumatic drugs Hypoalbuminemia (either before or during therapy) Diabetes mellitus [emedicine.medscape.com]

  […] multicentre, case–control study found an association between increasing age, previous treatment with other disease-modifying anti-rheumatic drugs (particularly gold, sulfasalazine and D -penicillamine), extra-articular manifestations, presence of diabetes and hypoalbuminemia [err.ersjournals.com]

• Polyps

  These symptoms resolve in a few weeks but may be followed by persistent rhinitis and the development of nasal polyps. Spirometry typically shows a variable obstructive ventilatory defect. [emedicine.medscape.com]

  A syndrome comprising asthma, nasal polyps and aspirin sensitivity has also been recognized. Other common drugs causing bronchoconstriction are antibiotics and contrast media used in radiology. [ispub.com]

Conditions that improve with immune suppressive treatment probably are not idiopathic pulmonary fibrosis. The toxicity and side effects of treatments can be serious. [medicinenet.com]

Sometimes the choices are difficult, especially when it’s a life-saving treatment. [blf.org.uk]

The primary goal in the treatment of ILD is to reduce the buildup of scar tissue. [hospitals.jefferson.edu]

The treatment is cessation of steroid therapy. [emedicine.medscape.com]

Topotecan is used primarily in the treatment of metastatic carcinoma of the ovary and as second-line treatment of small-cell lung cancer. [annonc.oxfordjournals.org]

(Outcomes/Resolutions) The prognosis of Drug-Induced Lung Disease varies from one individual to another. [dovemed.com]

The prognosis for non-cardiogenic pulmonary edema tends to be quite good upon withdrawal of the offending agent. [clinicaladvisor.com]

Outlook (Prognosis) Acute episodes usually go away within 48 to 72 hours after the medicine has been stopped. Chronic symptoms may take longer to improve. [ufhealth.org]

Prognosis ILD is second only to cardiac disease as a cause of mortality in rheumatoid arthritis [ 1, 7, 10 ]. [err.ersjournals.com]

The prognosis is good. Most patients improve after discontinuation of the gold therapy. Penicillamine Penicillamine is an anti-inflammatory agent mostly used in the treatment of rheumatoid arthritis. [emedicine.medscape.com]

Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]

Pathology Etiology 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 [radiopaedia.org]

(Etiology) Drug-Induced Lung Disease is caused by the use of certain medications/drugs that are injurious to the lungs. [dovemed.com]

Rubin RL: Etiology and mechanisms of drug-induced lupus. Curr Opin Rheumatol 1999;11:357–363. Goldman AL, Enquist R: Hyperacute radiation pneumonitis. Chest 1975;67:613–615. [karger.com]

Overview of ILD Interstitial lung diseases (ILD) are a heterogeneous group of diseases that produce inflammation and fibrosis of the parenchyma, affecting the alveolar, interstitial and vascular spaces. 5 Sometimes the causative etiology or mechanism [appliedradiology.com]

The Epidemiology of Interstitial Lung Diseases. Am J Respir Crit Care Med. Oct 1994;150(4):967-72. cited by Michaelson JE, Aguayo SM, Roman J. Idiopathic Pulmonary Fibrosis: A Practical Approach for Diagnosis and Management. Chest. [en.wikipedia.org]

The epidemiology of interstitial lung diseases. Am J Respir Crit Care Med. 1994;150:967-972. 7. Thomeer M, Costabel U, Rizzato G, et al. Comparison of registries of interstitial lung diseases in three European countries. [pharmacytimes.com]

Epidemiology The exact frequency of drug induced lung diseases is difficult to determine because of lack of an effective screening tool. Drug induced lung diseases are prevalent in both adults and children. [ispub.com]

The epidemiology of interstitial lung diseases Am J Respir Crit Care Med 1994; 150: 967-72., 13 Thomeer M, Costabel U, Rizzato G, et al. [benthamopen.com]

Epidemiology The occurence of drug-related pulmonary toxicity remains largely unpredictable and idiosyncratic. [clinicaladvisor.com]

Eosinophilic pneumonia Eosinophilic pneumonia is similar to organizing pneumonia in pathophysiology, but is mediated instead by an inappropriate increase in the number of eosinophils and macrophages in alveoli. [appliedradiology.com]

Clinical presentation, pathophysiology, diagnostic findings, and treatment strategies are reviewed. The patient was successfully managed with pulse high dose steroid therapy. Key words: Amiodarone; pulmonary toxicity Submitted Mar 02, 2012. [jtd.amegroups.com]

A delayed-type hypersensitivity reaction involving immunological and non-immunological mechanisms has been proposed as a possible pathophysiological mechanism [ 45 ]. [annonc.oxfordjournals.org]

Pathophysiology Pulmonary toxicity secondary to drugs may be due to a variety of mechanisms, including oxidant injury, deposition of phospholipids within the cells, immune system-mediated injury and central nervous system depression. [clinicaladvisor.com]

Furthermore, we know two other pathophysiologic principles in pulmonary toxicity [ 75 Kaarteenaho R, Kinnula V. Diffuse alveolar damage: A common phenomenon in progressive interstitial lung disorders Pulm Med 2011; 2011: 531302. ]. [benthamopen.com]

Now in its second edition, this popular and essential comprehensive resource provides a detailed analysis of how to identify, prevent, and manage drug-induced diseases. Edited by James E. Tisdale and Douglas A. [books.google.de]

If lung damage occurs, the dose of the drug may be lowered or the drug may be stopped altogether to prevent further damage. [cancer.ca]

Hypoxia can be prevented with oxygen supplementation. [2] Pulmonary fibrosis may also result in an increased risk for pulmonary emboli, which can be prevented by anticoagulants. [2] Epidemiology [ edit ] Five million people worldwide are affected by pulmonary [en.wikipedia.org]

Preventive measures for Drug-Induced Lung Disease may include: Individuals who are recommended drugs that may cause lung damage should be closely observed and monitored In all these individuals, baseline tests to evaluate lung function should be carried [dovemed.com]

Therefore, patients with pulmonary fibrosis are frequently treated with supplemental oxygen therapy to prevent pulmonary hypertension. [medicinenet.com]