Complications pulmonaires des traitements des maladies systémiques

Systemic inflammatory diseases are often treated with immunosuppressive drugs. These drugs increase the risk of infection with bacterial, viral or fungal agents. They may also occasion lung disease in their own right. Methotrexate and leflunomide, used to treat rheumatoid arthritis, may cause several patterns of interstitial pneumonia. Pneumocystis pneumonia may also occur with these medications and it is crucially important to rule out this condition in such cases. Some patterns of drug-induced disease may mimic systemic conditions such as DRESS, or systemic vasculitis. Biological agents such as anti-TNF drugs may cause anaphylaxis and/or interstitial lung disease, though proof for causality is often lacking, and opportunistic infections, particularly tuberculosis. In consequence the onset of new respiratory symptoms dictates that the role of drugs in their pathogenesis should be evaluated using the online Pneumotox website.