Abstract
Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, which may be related to different causes. A low percentage of these lung diseases may be secondary to the administration of drugs or substances. Through the PubMed database, an extensive search was performed in the fields of drug toxicity and interstitial lung disease. We have evaluated the different classes of drugs associated with pulmonary toxicity. Several different high resolution computed tomography (HRCT) patterns related to pulmonary drug toxicity have been reported in literature, and the most frequent ILDs patterns reported include Nonspecific Interstitial Pneumonia (NSIP), Usual Interstitial Pneumonia (UIP), Hypersensitivity Pneumonitis (HP), Organizing Pneumonia (OP), Acute Respiratory Distress Syndrome (ARDS), and Diffuse Alveolar Damage (DAD). Finally, from the electronic database of our Institute we have selected and commented on some cases of drug-induced lung diseases related to the administration of common drugs. As the imaging patterns are rarely specific, an accurate evaluation of the clinical history is required and a multidisciplinary approach—involving pneumologists, cardiologists, radiologists, pathologists, and rheumatologists—is recommended.
Highlights
Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, characterized by high morbidity and mortality; they have been classified into four categories: (1) diseases with known causes, (2) Idiopathic Interstitial Pneumonias (IIPs), (3) granulomatous diseases, and (4) other or miscellaneous disorders
The purpose of this paper is to illustrate the classes of drugs and the substances most frequently responsible for pulmonary toxicity; in addition, we provide a pictorial review of the most important radiological patterns, in order to provide a diagnostic address for radiologists
Some of the possible risk factors for the development of pulmonary toxicity-related to drug exposure have been described in literature [2,15]
Summary
Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, characterized by high morbidity and mortality; they have been classified into four categories: (1) diseases with known causes, (2) Idiopathic Interstitial Pneumonias (IIPs), (3) granulomatous diseases (e.g., sarcoidosis and chronic hypersensitivity pneumonias), and (4) other or miscellaneous disorders. Interstitial Lung Diseases (DILDs) have been included in the latter category, due to the fact that different radiological and morphological patterns have been associated to the administration of drugs [1,2]. Diagnostics 2020, 10, 244 from an intervention related to the use of a medicinal product, which predicts hazard from future administration and warrants prevention or specific treatment, or alteration of the dosage regimen, or withdrawal of the product” [3], and represents a common event in outpatients and hospitalized patients. The most common manifestations involve gastrointestinal or metabolic system, pulmonary toxicity seems to be relatively uncommon [5], and it constitutes, cumulatively, less than 10% of the causes of hospitalization for ADR [6]
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