Pneumotox » Drug » Hydralazine

Hydralazine

4

Last update : 01/11/2015

I.a Pneumonitis (ILD), acute and/or severe (may cause ARDS)

1

I.b Pneumonitis (ILD)

1

I.d Organizing pneumonia pattern (an area or areas of consolidation on imaging)

-

II.b ARDS - Acute lung injury

1

III.a Alveolar hemorrhage (AH), diffuse AH (DAH)

1

III.b Pneumorenal syndrome (w/wo ANCAs)

1

III.d Alveolar hemorrhage, diffuse (ANCA-positive/-related)

1

IV.a Bronchospasm - Wheezing - Asthma

-

V.d Pleural/pericardial effusion, ANA positive (DI lupus)

2

V.i Pleuritis (can cause chest pain)

1

V.m Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative)

1

VI.d Pulmonary vasculitis or capillaritis

1

VIII.a Angioedema (may cause UAO, asphyxia and death)

1

VIII.c Upper airway obstruction other than angioedema or hematoma

1

VIII.h Vocal cord dysfunction, adduction, closure, injury

1

X.a DRES syndrome - DRESS-like reaction

2

X.b Antiphospholipid antibodies w/wo the APL syndrome

1

X.d Lupus - Lupus syndrome (see also Vd)

3

X.e Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs)

2

X.m Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative)

1

X.o Neutrophilic dermatosis (Pyoderma, Sweet syndrome)

1

X.s Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive

2

X.ak Dual MPO-/PR3-ANCA systemic disease/vasculitis/pseudovasculitis

1

XII.c Pericardial effusion (w/wo tamponade)

1

XII.k Constrictive pericarditis - Pericardial thickening

1

XV.f Path: Diffuse alveolar damage (DAD-pattern) (see also IL)

1

Diagnosing DIRD

1

Drug and radiation history

2

Drug singularity - Correct identification of the drug

3

Consistent timing of exposure v. onset of symptoms

4

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

5

Careful exlusion of another cause

6

Remission of symptoms with removal of drug

7

Recurrence with rechallenge (rarely advisable)

8

Causality assessment

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