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Diagnosing DIRD
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The Drug-Induced Respiratory Disease Website
Philippe Camus, M.D.
Dijon, France
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Drugs
Patterns
Vincristine
2
Last update :
13/08/2023
I - Interstitial/parenchymal lung disease
I.b
Pneumonitis (ILD)
1
VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.e
Laryngospasm (a.k.a. laryngismus)
1
VIII.h
Vocal cord dysfunction, adduction, closure, injury
1
VIII.j
Laryngeal disorder-Laryngeal nerve palsy (dysphonia, hoarseness)
1
XV - Pathology
XV.a
Path: NSIP-cellular pattern (see also Ia, Ib)
1
XV.i
Path: Pneumocyte atypia (reactive epithelial cells) (a.k.a. the "Napoleon Hat" sign)
1
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Identify causative drugs
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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