Drug induced pneumonitides
Transtuzumab
induced organizing pneumonia: a case report. CECT of the Chest revealing. a Extensive right upper lobe consolidation, bronchocentric consolidation with air bronchogram, band like and peripheral consolidation and b the “reversed halo” sign of focal perilobular consolidation with central ground-glass opacities suggestive of organizing pneumonia. c, d CECT of the Chest before discharge revealing marked resolution of the organizing pneumonia after cessation of transtuzumab
High
incidence and early onset of nivolumab-induced pneumonitis: four case reports and literature review. Computed tomography image of nivolumab-induced pneumonitis in Case 1. On the 17th day of nivolumab treatment, non-segmental ground-glass opacities developed at lower lobes of the bilateral lungs
High
incidence and early onset of nivolumab-induced pneumonitis: four case reports and literature review. Computed tomography image of nivolumab-induced pneumonitis in Case 2. Multiple consolidations and ground-glass opacities developed at both lungs
High
incidence and early onset of nivolumab-induced pneumonitis: four case reports and literature review. Computed tomography images of nivolumab-induced pneumonitis in Case 3. a Non-segmental ground-glass opacities and consolidations were observed in a predominantly subpleural distribution at both lungs on the 14th day of the initial nivolumab treatment. b After the predominant lesion at the right lung in the initial disease episode was reduced, the similar opacity was newly observed at the left lung in the time of relapse
High
incidence and early onset of nivolumab-induced pneumonitis: four case reports and literature review. Computed tomography images of nivolumab-induced pneumonitis in Case 4. Multiple consolidations and ground-glass opacities developed at both lungs
Methotrexate-induced
Hypersensitivity Pneumonitis appearing after 30 years of use: a case report. Patient’s chest computed tomography on admission
Methotrexate-induced
pneumonitis in Crohn"s disease. Case report and review of the literature. HRCT of lung during methotrexate therapy. Diffuse bilateral alveolar infiltrates and ground glass areas can be seen without distortion of pulmonary parenchyma. Definition of abbreviation: HRCT, high-resolution computed tomography.
Drug-induced
lung disease • Drug induced interstitial lung disease - Ganzer Fall bei Radiopaedia
Drug-induced
lung disease • Amiodarone lung - Ganzer Fall bei Radiopaedia
Drug-induced
lung disease • Rituximab-induced interstitial lung disease - Ganzer Fall bei Radiopaedia
Drug-induced
lung disease • Immunotherapy-induced pneumonitis - metastatic melanoma - Ganzer Fall bei Radiopaedia
Drug-induced
lung disease • Gemcitabine lung toxicity - Ganzer Fall bei Radiopaedia
Drug-induced
lung disease • Drug-induced lung injury - nab-paclitaxel/gemcitabine - Ganzer Fall bei Radiopaedia
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 :
- interstitial fibrosis: typically NSIP pattern
- hypersensitivity pneumonitis pattern
- adult respiratory distress syndrome / diffuse alveolar damage pattern
- bronchiolitis obliterans organizing pneumonia type pattern
- pulmonary hemorrhage
Example agents include:
- bleomycin lung toxicity
- busulfan lung toxicity
- carmustine lung toxicity
- chlorambucil lung toxicity
- cyclophosphamide toxicity
- docetaxel induced interstitial pneumonitis
- gemcitabine lung toxicity
- melphalan associated pulmonary toxicity
- methotrexate lung disease
- paclitaxel lung toxicity
- pemtrexed - pemtrexed induced pneumonitis
- thalidomide-induced interstitial pneumonitis
Immunosuppressive agents
- sirolimus: sirolimus-associated pulmonary toxicity
- leflunomide (arava): leflunomide-induced acute interstitial pneumonia
- sulfasalazine lung toxicity
Immunotherapy agents
Immune checkpoint inhibitor therapy-related pneumonitis / immune-mediated pneumonitis usually happens between 8 to 14 weeks after the start of treatment . Examples of agents include:
- nivolumab
- pembrolizumab
- pembrolizumab-induced sarcoid-like reaction
- pembrolizumab-induced pneumonitis
- ipilimumab
Cardiovascular agents
- amiodarone lung toxicity
Antibiotic agents
Can also give similar patterns to that of chemotherapeutic agents.
Examples include:
- nitrofurantoin lung toxicity
- amphotericin B lung toxicity
- sulfonamide lung toxicity
Anti-inflammatory agents
- gold-induced lung toxicity
Recreational drugs
- IV methylphenidate (Ritalin lung): panacinar emphysema
- IV heroin : pulmonary edema, pulmonary hemorrhage, eosinophilic pneumonia
- IV cocaine: pulmonary edema
- vaping associated lung disease
Anticonvulsants
- phenytoin: eosinophilic pneumonia
Others
Accidental inhalation or ingestion of various agents:
- herbicides
- paraquat (N,N′-dimethyl-4,4′-bipyridinium dichloride): paraquat-induced lung disease
Siehe auch:
- Kryptogene organisierende Pneumonie (COP)
- Hypersensitivitätspneumonitis
- Lungenfibrose
- acute respiratory distress syndrome (ARDS)
- Lungenblutung
- non specific interstitial pneumonia (NSIP)
- Ritalinlunge
- Bleomycin induzierte Pneumonitis
- pleuroparenchymale Fibroelastose
- Methotrexat induzierte Pneumonitis
- Amiodaronlunge
- paraquat induced lung disease
- diffuser Alveolarschaden
- pan acinar emphysema
Assoziationen und Differentialdiagnosen zu medikamenteninduzierte Pneumonitis:
