Learning objectives
1)Clinical presentation of DILD and imaging modalities for diagnosis of DILD.
2) Role of the radiologist in the investigation of Drug-Induced Interstitial Lung Disease ( DILD ).
3) Radiological patterns of DILD and manifestations of common cytotoxic and non-cytotoxic DILD.
Background
Drug Induced Lung Disease (DILD) is an iatrogenic lung injury secondary to drug exposure.
It can be a debilitating and even life-threatening condition affecting the lung parenchyma,
airways,
pulmonary vasculature,
pulmonary interstitium and pleura.
Both cytotoxic and non-cytotoxic drugs including antimicrobials,
anti-Inflammatory,
biologics & cardiovascular medication can cause DILD.
Patients on chemotherapy or patients with systemic inflammatory diseases are at increased risk.
The toxicity can be direct,
dose-dependent or immune-mediated.
Clinical history,
examination findings,
imaging tests and non-imaging tests aid the diagnosis.
Various non-imaging tests...
Findings and procedure details
Drug Induced Lung Disease (DILD) is an iatrogenic lung injury secondary to drug exposure.
It can be a debilitating and even life-threatening condition affecting the lung parenchyma,
airways,
pulmonary vasculature,
pulmonary interstitium and pleura.
Both cytotoxic and non-cytotoxic drugs including antimicrobials,
anti-inflammatory,
biologics & cardiovascular medication can cause DILD.
Patients on chemotherapy or patients with systemic inflammatory diseases are at increased risk.
The toxicity can be direct,
dose-dependent or immune-mediated.
Clinical history,
examination findings,
imaging tests and non-imaging tests aid the diagnosis.
DILD has no...
Conclusion
Drug-induced interstitial lung disease is a potentially life-threatening condition and the radiologist has a key role to play in early diagnosis by raising the possibility,
defining the various DILD patterns,
ruling out other differential diagnosis and aid the clinician in monitoring treatment response.
There are no pathognomonic imaging features of DILD.
Following new drug therapy,
the presence of either new diffuse alveolar damage,
hypersensitivity pneumonitis,
non-specific interstitial pneumonia,
organising pneumonia or fibrosis (in chronic disease) favours the diagnosis of DILD.
Improvement of these imaging findings...
Personal information
Dr.Dheeraj Giri,
Speciality trainee (Intern) in Radiology.
University Hospitals of Leicester NHS Trust.
Leicester,
UK.
E-mail:
[email protected]
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