drug-induced interstitial lung disease

Etiology

• chemotherapeutic agents & immunosuppressants
  • bleomycin
  • busulfan
  • nitrosourea
  • mitomycin C
  • cyclophosphamide
  • methotrexate
  • azathioprine
  • imatinib
• amiodarone
• antibiotics
  • nitrofurantoin
  • ethambutol
  • isoniazid
  • amphotericin B
  • sulfonamides
• carbamazepine
• antidepressants
  • fluoxetine
  • trazodone
• drug-induced lupus erythematosus
  • hydralazine
  • procainamide
• gold salts
• D-penicillamine
• methadone
• oxygen
• sulfasalazine
• cromolyn
• methysergide
• hezamethonium
• pentolinium
• mecamylamine
• diphenylhydantoin
• GM-CSF
• pituitary snuff
• inhalation cocaine
• intravenous talc
• aspirated oil

Clinical manifestations

• exposure history with temporal cause-effect relationship
• acute, subacute or chronic presentation
• pneumonitis & fibrosis
  • nitrofurantoin, bleomycin, methotrexate, amiodarone, gold salts, inhalation cocaine
• non-cardiogenic pulmonary edema
• fever, fatigue, cough
• pleural effusion
• pulmonary vasculitis
  • hydralazine, procainamide

Laboratory

eosinophilia

Radiology

• chest X-ray
• nonspecific pulmonary inflammation & fibrosis
• noncaseating granuloma in methotrexate pneumonitis

Management

• cessation of the offending agent
• corticosteroids
• prompt clinical response to 1 & 2

More general terms

• interstitial lung disease

Additional terms

• radiation pneumonitis