HISTOLOGICAL AND CLINICAL FEATURES OF EMERGENCY PRESENTATIONS OF DRUG-INDUCED PNEUMONITIS

Background  To evaluate the clinical, radiological, and histopathological features of patients presenting acutely with drug-induced pneumonitis and to assess treatment outcomes. MethodsThis 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. ResultsDyspnea (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). ConclusionDrug-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.