Upadacitinib-induced interstitial pneumonitis

Drug-induced lung injury represents a heterogeneous group of adverse reactions, with an increasing number of implicated medications each year. We report a case of pneumonitis in a woman recently commenced on upadacitinib for ulcerative colitis. She presented with dyspnoea, dry cough and subjective fevers. High-resolution CT of the chest revealed diffuse bilateral ground-glass opacities. Infectious and autoimmune causes were excluded. Upadacitinib was discontinued and corticosteroid therapy initiated, resulting in near-complete radiological resolution within 2 months. To our knowledge, this is the first reported case of upadacitinib-induced pneumonitis. Clinicians should remain vigilant for this potential adverse effect as the use of Janus kinase inhibitors expands.