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Type:
Educational Exhibit
Keywords:
Toxicity, Drugs / Reactions, Complications, Chemotherapy, CT-High Resolution, Conventional radiography, Thorax, Respiratory system, Lung
Authors:
D. Giri, S. Gupta, P. Rao, D. Barnes; Leicester/UK
DOI:
10.1594/ecr2016/C-1865
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 including lung function tests and histopathological correlation from bronchoalveolar lavage compliment the imaging findings.
DILD has no specific symptoms and may include shortness of breath,
cough,
dyspnoea or pleuritic chest pain.
A study noted increase in serum HSP47 levels in patients with DILD associated with a DAD pattern1.
Early recognition,
evaluation with Computed Tomography (CT) and prompt clinical management can reduce both morbidity and mortality.
Steroid therapy is known to aid recovery in DILD.
Radiologist plays a key role in diagnosis of DILD.