History of Lung Diseases: Iatrogenic Disorders
| Disease Category & Link | Progress, Diagnosis, Treatment, & Notable People |
| Drug-Induced Lung Disease | Progress: A vast category where the treatment (a drug) causes lung inflammation or scarring. This became a major field as chemotherapy and cardiac drugs were developed.
Diagnosis & Imaging: This is a diagnosis of exclusion (ruling out infection, etc.). The timing of a new drug is the biggest clue. Imaging patterns are critical:
Treatment: The primary treatment is stopping the offending drug. Corticosteroids are often used to suppress the inflammation. |
| Radiation-Induced Lung Disease | Progress: A direct consequence of radiation therapy for cancers like lung, breast, or lymphoma. It was first described in the 1920s after the initial use of radiation.
Diagnosis & Imaging: Imaging is the definitive diagnostic tool. The findings are sharply demarcated and conform to the shape of the radiation port, ignoring normal anatomical lung boundaries.
Treatment: Corticosteroids are the mainstay for the acute pneumonitis phase. The fibrosis is permanent. |
| Ventilator-Associated Lung Injury (VALI/VILI) | Progress: This is lung damage caused by the life-saving mechanical ventilator itself.
Diagnosis & Imaging: X-ray/CT: The key is to look for signs of barotrauma: pneumothorax (collapsed lung), pneumomediastinum (air in the center of the chest), and subcutaneous emphysema (air crackling under the skin). Treatment: The treatment is prevention. The ARDSNet trial (2000) proved that Low Tidal Volume Ventilation (using “baby lung” settings) saves lives. This is now the standard of care. |
| Post-Operative Atelectasis | Progress: The most common post-surgical lung complication. General anesthesia and pain from incisions cause “splinting” (shallow breaths), leading to the collapse of alveoli.
Diagnosis & Imaging: X-ray: The classic finding is linear, “plate-like” white lines at the lung bases. In severe cases (lobar collapse), it can show volume loss with a shifted trachea or a raised diaphragm. Treatment: Purely supportive and preventative. This is the entire reason for incentive spirometry and encouraging patients to “cough and deep breathe” after surgery. |
Notables Who Advanced Diagnosis & Management of Iatrogenic Disorders
| Name & Wikipedia Link | Comment on Contribution |
| The ARDSNet Investigators | This research group, funded by the NIH, conducted a landmark clinical trial (published in 2000) that proved Low Tidal Volume Ventilation saves lives. This study provided the evidence to prevent VILI (Ventilator-Induced Lung Injury) and is now the global standard of care for ventilated patients. |
| Dr. Philippe Camus & Team | Dr. Camus is a leading figure in the field of drug-induced lung disease. He is the founder and primary editor of www.pneumotox.com, the definitive online database that helps clinicians worldwide identify if a patient’s lung disease might be an iatrogenic side effect of a medication. |
| Drs. Zvi Fuks & Steven Leibel | (1940-2023) & (1946-2016) These two oncologists were pioneers at Memorial Sloan Kettering in the 1990s. They developed 3D-conformal radiation therapy and IMRT (Intensity-Modulated Radiation Therapy), which precisely shape radiation beams to avoid healthy tissue, dramatically reducing complications like radiation pneumonitis. |
| Dr. Robert H. Bartlett | While a surgeon known for pioneering ECMO, Dr. Bartlett also helped develop the modern incentive spirometer. This simple iatrogenic prevention device is given to almost every post-operative patient to prevent atelectasis by encouraging deep breathing. |
2. Notables Who Suffered from Iatrogenic Disorders
(Note: Iatrogenic diseases are medical complications, not public-facing illnesses, so this information is often private. The figures below are well-documented examples related to these conditions.)
| Name & Wikipedia Link | Comment on Disease |
| James Montgomery Boice | (1938–2000) A prominent American theologian and author. He was diagnosed with liver cancer and began chemotherapy. He died just 8 weeks later, not from the cancer, but from complications of drug-induced lung disease (specifically, pulmonary fibrosis) caused by the chemotherapy agent bleomycin. |
| Breast Cancer Survivors (as a group) | Many public figures and countless other survivors of breast cancer have been successfully treated with radiation therapy. A well-known side effect of this life-saving treatment is radiation pneumonitis, an inflammation of the lung in the radiation field that can progress to permanent radiation fibrosis. |
| ARDS Survivors (as a group) | Patients who survive severe ARDS (from COVID-19, sepsis, or trauma) often require long-term mechanical ventilation. Many of these survivors suffer from long-term lung scarring and breathing problems, which are a direct result of the life-saving ventilation (VILI) and the ARDS itself. |