HISTOLOGICAL AND CLINICAL FEATURES OF EMERGENCY PRESENTATIONS OF DRUG-INDUCED PNEUMONITIS
Main Article Content
Keywords
Drug-induced lung disease; Pneumonitis; Emergency presentation; Lung biopsy; Ground-glass opacities; Organizing pneumonia; Diffuse alveolar damage; Steroid therapy; HRCT chest
Abstract
Background
To evaluate the clinical, radiological, and histopathological features of patients presenting acutely with drug-induced pneumonitis and to assess treatment outcomes.
Methods
This cross-sectional study included 81 patients who presented to the emergency department with suspected drug-induced pneumonitis between January 2023 and January 2024. Detailed clinical history, radiological imaging, laboratory tests, and, where indicated, lung biopsies were performed. Data were analyzed to identify common presenting symptoms, radiological patterns, histologic types, and outcomes.
Results
Dyspnea (84%) and cough (75.3%) were the most frequent symptoms. Ground-glass opacities were observed in 76.5% of high-resolution CT scans. Organizing pneumonia and diffuse alveolar damage were the leading histopathological patterns among the 34 patients who underwent biopsy. Chemotherapy agents were the most common suspected cause (33.3%), followed by antibiotics (23.5%). Corticosteroid therapy led to clinical improvement in most cases, while mechanical ventilation was significantly associated with increased mortality (p = 0.041).
Conclusion
Drug-induced pneumonitis should be considered in patients presenting with acute respiratory symptoms, particularly those with recent exposure to known culprit medications. Early diagnosis supported by imaging and histology enables timely intervention and can significantly improve outcomes.
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Dr Muhammad Tariq Hamayun Khan
Assistant Professor of Hematology, Department of Pathology, Burns & Plastic Surgery Center Hayatabad Peshawar, Pakistan
Dr Hamidullah
Assistant Professor of Medicine, Bacha Khan Medical College, Mardan, Pakistan
Dr Naveed Pervez
Assistant Professor and Head of Department, Department of Pulmonology, MTI Bannu Medical College / Khalifa Gul Nawaz Teaching Hospital, Bannu, Pakistan
Dr Farhan Abbas Baloch
Associate Professor, Department of Pathology, Pak International Medical College, Peshawar, Pakistan
Dr Ihsan Ullah
Assistant Professor, Department of Pharmacology, Saidu Medical College, Swat, Pakistan
Dr Nadia Khan
Senior lecturer, Department of Anatomy, Jinnah Medical College, Peshawar, Pakistan