I.b
Pneumonitis (ILD)
Or 'ILD'. (Fr: PnP subaiguë). A.k.a. pulmonary infiltrates. Generally bilateral and symmetrical. Gradual onset. Consistent with but not specific for an NSIP-c pattern on pathology. Less- dense, severe, acute and diffuse than pattern Ia. Lacks the features of ARDS that may accompany pattern Ia. Can be in the form of disseminated linear, reticulonodular, miliary or patchy opacities. BAL is indicated to separate this pattern from PIE (Ic) or DAH (IIIa). Acute chest pain can be at the forefront. A search for microorganisms including Pneumocystis (stains, PCR) is indicated. On pathology (although not many cases undergo a confirmatory lung biopsy), there is interstitial inflammation and a more or less dense cellular interstitial cellular infiltrate (NSIP-c). Fibrosis, alveolar edema and/or a reactive epithelium denote those cases resulting from with antineoplastic chemotherapy agents. The frontier between patterns Ia and I b can be difficult to draw, so please check drugs under both Ia and Ib. Patients may quickly shift from pattern Ib to Ia particularly if the the causal drug is inappropriately continued. Prompt withdrawal must be considered, underlying disease permitting, and can be therapeutic.
Causative drugs
Temozolomide
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (May commpany ILDs) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.k XV - Pathology
XV.k - Path: Desquamative interstitial pneumonia (DIP-pattern) XVII.c XVII - Infections & related conditions
XVII.c - Aspergillosis, pulmonary (invasive, allergic [ABPA], or mycetoma) XVII.e XVII - Infections & related conditions
XVII.e - Pneumocystis jiroveci pneumonia XVII.aj XVII - Infections & related conditions
XVII.aj - Bordetella bronchiseptica pulmonary infection
Temsirolimus
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) XII.c XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade) XVII.h XVII - Infections & related conditions
XVII.h - Nontuberculous pulmonary mycobacterial infection/superinfection
Thalidomide
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes XIX.b XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.b - BAL: An excess proportion of neutrophils
Ticlopidine
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.k I - Interstitial/parenchymal lung disease
I.k - Lung nodule or nodules I.l I - Interstitial/parenchymal lung disease
I.l - Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) V.d V - Pleural and/or pericardial involvement
V.d - Pleural/pericardial effusion, ANA positive (DI lupus) V.e V - Pleural and/or pericardial involvement
V.e - Hemothorax - Serosanguineous pleural effusion X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd)
Timolol
I.b - Pneumonitis (ILD) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.f IV - Airway involvement
IV.f - Severe or catastrophic bronchospasm or asthma attack (can be fatal) V.d V - Pleural and/or pericardial involvement
V.d - Pleural/pericardial effusion, ANA positive (DI lupus) IX.d IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.d - Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)
Tiopronine
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) IV.c IV - Airway involvement
IV.c - Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx) X.j X - Systemic/Distant conditions, syndromes and reactions
X.j - Myopathy-Myositis-Polymyositis (see also under Xba) XI.t XI - Miscellaneous
XI.t - Yellow nail syndrome
Tocainide
I.b - Pneumonitis (ILD) I.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis V.d V - Pleural and/or pericardial involvement
V.d - Pleural/pericardial effusion, ANA positive (DI lupus) X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) XI.n XI - Miscellaneous
XI.n - Neutropenia, agranulocytosis (w/wo infection/sepsis) XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XV.k XV - Pathology
XV.k - Path: Desquamative interstitial pneumonia (DIP-pattern)
Tocilizumab
I.b - Pneumonitis (ILD) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis VIII.h VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.h - Vocal cord dysfunction, adduction, closure, injury X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) XVII.b XVII - Infections & related conditions
XVII.b - Opportunistic pulmonary/systemic infections XVII.g XVII - Infections & related conditions
XVII.g - Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo XVII.ah XVII - Infections & related conditions
XVII.ah - Pulmonary pasteurellosis
Tofacitinib
I.b - Pneumonitis (ILD) VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension XVII.b XVII - Infections & related conditions
XVII.b - Opportunistic pulmonary/systemic infections XVII.e XVII - Infections & related conditions
XVII.e - Pneumocystis jiroveci pneumonia XVII.g XVII - Infections & related conditions
XVII.g - Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo XVII.h XVII - Infections & related conditions
XVII.h - Nontuberculous pulmonary mycobacterial infection/superinfection XVII.q XVII - Infections & related conditions
XVII.q - Viral pneumonia XVII.y XVII - Infections & related conditions
XVII.y - Cryptococcus pulmonary and/or systemic infection
Trametinib
I.b - Pneumonitis (ILD) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) X.ah X - Systemic/Distant conditions, syndromes and reactions
X.ah - Granulomatosis with polyangiitis (typically ANCA pos.) - GPA flare XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension
Transhepatic arterial chemoembolization (TACE)
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis I.z I - Interstitial/parenchymal lung disease
I.z - An area or areas of consolidation II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (May commpany ILDs) VI.a VI - Pulmonary vasculopathies
VI.a - Pulmonary embolism - Venous thrombosis/thromboembolism VI.e VI - Pulmonary vasculopathies
VI.e - Fat/oil embolism - The FES embolism syndrome VI.v VI - Pulmonary vasculopathies
VI.v - Foreign body/substance pulmonary embolism VI.aa VI - Pulmonary vasculopathies
VI.aa - Lipiodol pulmonary embolism XI.aa XI - Miscellaneous
XI.aa - CNS symptoms or involvement, stroke XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XVI.s XVI - Imaging
XVI.s - Imaging: An area or areas of involvement with high attenuation numbers or metallic density XVIII.h XVIII - Distinctive patterns - 'Eye-catchers'
XVIII.h - Eye-catcher: Lipiodol embolism
Trastuzumab
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IX.ab IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.ab - Guillain-Barré (or GB-like) syndrome (w/wo ARF) X.c X - Systemic/Distant conditions, syndromes and reactions
X.c - Capillary leak syndrome (CLS) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) X.ae X - Systemic/Distant conditions, syndromes and reactions
X.ae - Antisynthetase antibodies (ASA) - ASA syndrome XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic) XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP) XII.p XII - Cardiovascular involvement / toxicity
XII.p - QTc prolongation XII.ai XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity
Trastuzumab deruxtecan
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.h I - Interstitial/parenchymal lung disease
I.h - Subclinical pulmonary infiltrates/ILD II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury
Trastuzumab emtansine (Ado-trastuzumab emtansine - TDM-1)
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
Trimethoprim sulfamethoxazole (TMP-SMX)
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.u II - Pulmonary edema - Acute lung injury - ARDS
II.u - Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.e X - Systemic/Distant conditions, syndromes and reactions
X.e - Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) X.x X - Systemic/Distant conditions, syndromes and reactions
X.x - Subclinical ANCA positivity XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.ct XV - Pathology
XV.ct - Path: Delayed alveolar injury with delayed epithelialization (DAIDE) XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
Tryptophan (l-tryptophan, synthetic)
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (May commpany ILDs) VI.b VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis VI.k VI - Pulmonary vasculopathies
VI.k - Eosinophilic pulmonary vasculitis X.v X - Systemic/Distant conditions, syndromes and reactions
X.v - Systemic eosinophilic syndrome w/wo vasculitis (see also Xa) X.w X - Systemic/Distant conditions, syndromes and reactions
X.w - Eosinophilia myalgia syndrome (EMS) X.ax X - Systemic/Distant conditions, syndromes and reactions
X.ax - Scleroderma XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic) XV.m XV - Pathology
XV.m - Path: Lymphoid hyperplasia (including nodular- or a lymphocytic interstitial pneumonia pattern)
Tyrosine kinase inhibitors (EGFR) TKI
I.b - Pneumonitis (ILD) I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) III.c III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.c - Hemoptysis V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax XII.a XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure