Pneumotox » Drug » Sirolimus

Sirolimus

4

See also under 'mTOR' inhibitors

Last update : 05/05/2012

I.a Pneumonitis (ILD), acute and/or severe (may cause ARDS)

2

I.b Pneumonitis (ILD)

3

I.d Organizing pneumonia pattern (an area or areas of consolidation on imaging)

2

I.f Acute fibrinous organizing pneumonia (AFOP)

1

I.l Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf)

1

I.m ILD with a granulomatous component

1

I.n Pulmonary alveolar proteinosis (PAP)

1

II.b ARDS - Acute lung injury

1

III.a Alveolar hemorrhage (AH), diffuse AH (DAH)

2

IV.d Cough (lone)

1

IV.l Bronchial stump dehiscence

1

V.m Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative)

1

VI.a Pulmonary embolism - Venous thrombosis/thromboembolism

1

VI.d Pulmonary vasculitis or capillaritis

1

VI.f Hemolytic and uremic syndrome (HUS). See also under Xaf

1

VIII.a Angioedema (may cause UAO, asphyxia and death)

1

X.c Capillary leak syndrome (CLS)

1

XII.c Pericardial effusion (w/wo tamponade)

1

XV.c Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)

2

XV.d Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also If)

1

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

2

XV.f Path: Diffuse alveolar damage (DAD-pattern) (see also IL)

1

XV.g Path: Alveolar hemorrhage (see also IIIa)

2

XV.k Path: Desquamative interstitial pneumonia (DIP-pattern)

1

XV.m Path: Lymphoid hyperplasia (including nodular- or a lymphocytic interstitial pneumonia pattern)

1

XV.n Path: Pulmonary alveolar proteinosis pattern (PAP pattern)

1

XV.ac Path: Pulmonary vasculitis other than capillaritis

1

XV.bf Path: Pulmonary necrotizing granuloma or granulomas

1

XVI.b Imaging: Ground-glass opacities (GGO) / shadowing

1

XVI.k Imaging: An area or areas of consolidation

1

XVII.b Opportunistic pulmonary/systemic infections

1

XVII.e Pneumocystis jiroveci pneumonia

1

XIX.a BAL: An excess proportion of lymphocytes

1

Diagnosing DIRD

1

Drug and radiation history

2

Drug singularity - Correct identification of the drug

3

Consistent timing of exposure v. onset of symptoms

4

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

5

Careful exlusion of another cause

6

Remission of symptoms with removal of drug

7

Recurrence with rechallenge (rarely advisable)

8

Causality assessment

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