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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
Atezolizumab
2
I.a
Pneumonitis (ILD), acute and/or severe (may cause ARDS)
1
Can be refractory to corticosteroids (PMID 30837232)
Last update :
10/03/2019
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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
More detailed checklist
See also under
Immune checkpoint inhibitors (ICI) - ICI combinatorial Rx
Publications
Immunotherapy causing pneumonitis in a patient with non-small cell lung cancer (NSCLC).
Pneumotoxicity associated with immune checkpoint inhibitor therapies.
Immune-mediated respiratory adverse events of checkpoint inhibitors.