ABSTRACT
In contrast to drug-induced parenchymal disease, drug-induced pleural disease is relatively uncommon. A pleural effusion is the most common manifestation, which can also cause chest pain, pleural fibrosis and pneumothorax. The mechanisms responsible for drug-induced pleural disease include: a hypersensitivity or allergic reaction; a direct toxic effect; enhanced oxygen free radical production; suppression of antioxidant defence mechanisms; and chemical-induced inflammation. Categories of drugs that are associated with pleural disease include cardiovascular agents, chemotherapeutic agents, ergoline drugs, sclerosing agents, and other classes of drugs that include cytokines, chelating agents, diabetes drugs, statins and antidepressants. The class III antiarrythmic drug amiodarone is an iodinated benzofuran, approved for the management of ventricular and supraventricular dysarrythmias. Bleomycin, an antitumour antimicrobial agent, is used in the treatment of head and neck cancers, testicular carcinoma, and Hodgkin’s and non-Hodgkin’s lymphoma. Chronic use of bromocriptine and other dopamine agonists or the ergoline methysergide can induce pleuropulmonary pathology.
