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
Ustekinumab
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.h I - Interstitial/parenchymal lung disease
I.h - Subclinical pulmonary infiltrates/ILD I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) 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.h XVII - Infections & related conditions
XVII.h - Nontuberculous pulmonary mycobacterial infection/superinfection XVII.n XVII - Infections & related conditions
XVII.n - Legionella pneumophila pneumonia XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
Vaccination - Immunization
I.b - Pneumonitis (ILD) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id) XVI.b XVI - Imaging
XVI.b - Imaging: Ground-glass opacities (GGO) / shadowing
Vaccines
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 II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) X.b X - Systemic/Distant conditions, syndromes and reactions
X.b - Antiphospholipid antibodies w/wo the APL syndrome X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) X.s X - Systemic/Distant conditions, syndromes and reactions
X.s - Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive
Valproate (Valproic acid)
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) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (May commpany ILDs) V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)
Vedolizumab
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.k I - Interstitial/parenchymal lung disease
I.k - Lung nodule or nodules II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury IV.c IV - Airway involvement
IV.c - Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx) VIII.aq VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.aq - Bronchorrhea 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.o X - Systemic/Distant conditions, syndromes and reactions
X.o - Neutrophilic dermatosis (Pyoderma, Sweet syndrome) XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic) 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) XV.x XV - Pathology
XV.x - Path: Acute/subacute bronchiolitis (see also IVc, IVi) XV.cn XV - Pathology
XV.cn - Path: Pulmonary necrotizing granuloma with neutrophilic microabscesses XVI.g XVI - Imaging
XVI.g - Imaging: Diffuse whiteout/alveolar shadowing (see also under IIb-ARDS) XVI.v XVI - Imaging
XVI.v - Imaging: Centrilobular micronodules (can be diffuse) XVII.a XVII - Infections & related conditions
XVII.a - Respiratory tract infection incl. pneumonia XVII.v XVII - Infections & related conditions
XVII.v - Strongyloides stercoralis hyperinfection (w/wo DAH)
Vemurafenib
I.b - Pneumonitis (ILD) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component I.ad I - Interstitial/parenchymal lung disease
I.ad - Radiation recall pneumonitis X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) XII.ai XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im)
Venlafaxine
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.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic) XII.g XII - Cardiovascular involvement / toxicity
XII.g - Coronary artery disease (acute) - Myocardial ischemia/infarction XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP) XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic)
Vildagliptin
I.b - Pneumonitis (ILD) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib)
Vinblastine
I.b - Pneumonitis (ILD) 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) 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 IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma XII.g XII - Cardiovascular involvement / toxicity
XII.g - Coronary artery disease (acute) - Myocardial ischemia/infarction XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL)
Vincristine
I.b - Pneumonitis (ILD) VIII.e VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.e - Laryngospasm (a.k.a. laryngismus) VIII.h VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.h - Vocal cord dysfunction, adduction, closure, injury VIII.j VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.j - Laryngeal disorder-Laryngeal nerve palsy (dysphonia, hoarseness) XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.i XV - Pathology
XV.i - Path: Pneumocyte atypia (reactive epithelial cells) (a.k.a. the "Napoleon Hat" sign)
Vindesine
I.b - Pneumonitis (ILD) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.n IV - Airway involvement
IV.n - Obstructive airway dysfunction (see also IVc, XVx)
Vinorelbine
I.b - Pneumonitis (ILD) 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 IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac- cardiorespiratory/pulmonary arrest
Waterproofing agents/sprays - Household cleansing agents and aerosols
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) 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 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) XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia