Camus Philippe, Fanton Annlyse, Bonniaud Philippe, Camus Clio, Foucher Pascal
Department of Pulmonary and Intensive Care, University Medical Center Le Bocage and Medical School, Université de Bourgogne, Dijon, France.
Respiration. 2004 Jul-Aug;71(4):301-26. doi: 10.1159/000079633.
An ever-increasing number of drugs can reproduce variegated patterns of naturally occurring interstitial lung disease (ILD), including most forms of interstitial pneumonias, alveolar involvement and, rarely, vasculitis. Drugs in one therapeutic class may collectively produce the same pattern of involvement. A few drugs can produce more than one pattern of ILD. The diagnosis of drug-induced ILD (DI-ILD) essentially rests on the temporal association between exposure to the drug and the development of pulmonary infiltrates. The histopathological features of DI-ILD are generally consistent, rather than suggestive or specific to the drug etiology. Thus, the diagnosis of DI-ILD is mainly made by the meticulous exclusion of all other possible causes. Drug dechallenge produces measurable improvement in symptoms and imaging in the majority of patients, whereas corticosteroid therapy is indicated if symptoms are present or drug dechallenge is without an effect. Rechallenge is justified in a minority of patients, and is discouraged for diagnostic purposes only. Pneumotox (www.pneumotox.com) provides updated information on drug-induced respiratory disease.
越来越多的药物能够引发各种自然发生的间质性肺疾病（ILD）的多样模式，包括大多数形式的间质性肺炎、肺泡受累，以及罕见的血管炎。同一治疗类别的药物可能共同导致相同的受累模式。少数药物可引发不止一种ILD模式。药物性ILD（DI-ILD）的诊断主要基于用药与肺部浸润发展之间的时间关联。DI-ILD的组织病理学特征通常较为一致，而非提示或特定于药物病因。因此，DI-ILD的诊断主要通过细致排除所有其他可能病因来做出。药物撤用在大多数患者中可使症状和影像学表现得到可测量的改善，而如果出现症状或药物撤用无效，则需使用皮质类固醇治疗。少数患者再次用药是合理的，仅出于诊断目的不鼓励再次用药。Pneumotox（www.pneumotox.com）提供有关药物性呼吸道疾病的最新信息。
