Drug-induced infiltrative lung disease.

An increasing number of drugs are recognized to induce distinctive patterns of infiltrative lung disease (ILD), ranging from benign infiltrates to life-threatening adult respiratory distress syndromes. In addition to drugs, biomolecules such as proteins and cytokines, and medicinal plants are also capable of inducing respiratory disease, some being severe and/or irreversible. For several reasons it is difficult to estimate the exact frequency of drug-induced infiltrative lung disease (DI-ILD). The risk for DI-ILD and the clinical patterns vary depending on a variety of host and drug factors. Although establishing the diagnosis is often difficult, systematic evaluation of the possible role of almost any kind of drugs in ILD is warranted, as stopping a drug may favourably influence prognosis. However, prognosis depends on the drug and the type of DI-ILD. Corticosteroids may suppress the inflammatory reaction, but for many drugs, proof of the effect of corticosteroids is lacking. Advances in prevention and prediction are needed. A user-friendly database of respiratory adverse drug reactions was made available on the web, to provide quick information in this area.