XV.e

Path: ILD with a granulomatous component (see also Im)

Corresponds clinically to acute or subacute ILD (typically with a miliary pattern) at times with the features of ARDS. Can be an incidental finding. Sometimes, granulomas are found in other organs as well. Most drug-induced pulmonary granulomas are nonnecrotizing in nature. Depending on context and country of origin and residence, special stains and molecular techniques are indicated to evidence mycobacteria, Pneumocystis, or other microorganisms, particularly if patients were receiving immunosuppressive drugs, rituximab or an anti-TNF agent, or if necrosis is present. Pneumocystis pneumonia can also assume this pattern (PMID 20414100, 22948319). Rare cases of necrotizing granulomas have been reported with the use of BCG, methotrexate and marijuana. See also under infection-tuberculosis. Large series of granulomatous lung disease at PMID 20441499, 22011444, 23558582

Last update : 03/01/2014
 

Causative drugs

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