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Medikamentös induzierte Lungenerkrankungen

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Seltene Lungenerkrankungen

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Zusammenfassung

Medikamentennebenwirkungen an den Atmungsorganen können vielfältige bronchopulmonale und pleurale Erkrankungen induzieren. Das Spektrum reicht vom banalen Husten über die Induktion von Bronchialobstruktionen bis hin zur Bronchiolitis obliterans. Im Lungenparenchym treten Alveolitiden und Lungenfibrosen auf. Weitere Reaktionsmuster sind das nichtkardiogene Lungenödem, die diffuse alveoläre Hämorrhagie, die Ausbildung eines ARDS, eosinophile Lungenerkrankungen, pulmonal-vaskuläre Krankheiten und Pleuritiden. Sie können vital bedrohlich verlaufen. Neuartige Therapien können zu bisher unbekannten bronchopulmonalen Schädigungsmustern führen. Selten liegt ein pathognomonisches Muster vor, sodass medikamenteninduzierte Erkrankungen meist eine Differenzialdiagnose von genuinen pneumologischen Krankheiten darstellen. Die Diagnostik stützt sich vorwiegend auf den Nachweis eines kompatiblen Krankheitsbildes, den Ausschluss von Differenzialdiagnosen, die Bewertung des zeitlichen Zusammenhangs und der Effekte einer Medikamentenkarenz. In-vitro-Untersuchungen sind nicht ausreichend validiert und haben bisher keine praktische Bedeutung. Eine Reexposition ist selten indiziert. Die Karenz ist die wichtigste therapeutische Maßnahme, eine zusätzliche medikamentöse Therapie, meist mit Kortikosteroiden, kann notwendig  sein.

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Author information

Authors and Affiliations

  1. Klinik für Pneumologie, Universitätsklinikum Magdeburg der Otto-von-Guerike-Universität, Magdeburg, Deutschland

    Jens Schreiber

  2. Department of Pulmonary Medicine and Intensive Care, Centre Hospitalier Unviversitaire Dijon, Dijon Cedex, France

    Philippe Camus

Authors
  1. Jens Schreiber
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  2. Philippe Camus
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Corresponding author

Correspondence to Jens Schreiber .

Editor information

Editors and Affiliations

  1. Zentrum für interstitielle und seltene Lungenerkrankungen, Thoraxklinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Michael Kreuter

  2. Ruhrlandklinik, Universitätsmedizin Essen, Essen, Deutschland

    Ulrich Costabel

  3. Thoraxklinik, Pneumologie und Beatmungsmedizin und Translational Lung Research Center (TLRCH), Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Felix JF Herth

  4. Vormals LungenClinic Grosshansdorf, Grosshansdorf, Deutschland

    Detlef Kirsten

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Schreiber, J., Camus, P. (2022). Medikamentös induzierte Lungenerkrankungen. In: Kreuter, M., Costabel, U., Herth, F.J., Kirsten, D. (eds) Seltene Lungenerkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63651-0_10

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  • DOI: https://doi.org/10.1007/978-3-662-63651-0_10

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  • Online ISBN: 978-3-662-63651-0

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