[Clinicopathological manifestations of drug-induced lung injury]

To investigate the clinicopathological features of drug-induced lung injury.

The clinical, radiological and pathological presentations of drug-induced lung injury diagnosed from January 2003 to October 2005 in Peking Union Medical College Hospital were reviewed.

There were 7 cases of drug-induced lung injury, 3 caused by amiodarone, and the other 4 caused by interferon-alpha, atorvastatin, carbamazepine, and propylthiouracil respectively. The clinical manifestations included cough, fever, worsening dyspnea and inspiratory crackles. Patchy infiltration, ground-glass attenuation with thickening of bronchovascular markings were the main findings in computed tomography. The most common pathological manifestation was cellular interstitial pneumonia associated with intra-alveolar macrophages with fine vacuolation in the cytoplasm, and type II pneumocyte hyperplasia. The organizing pneumonia pattern was observed in 2 patients. Diffuse alveolar hemorrhage was present in 2 cases.

Drug-induced pulmonary toxicity can be difficult to diagnose. The diagnosis of pulmonary drug toxicity should be considered in patients with a history of drug therapy and new onset or progressive respiratory complaints.