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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
TNF-alpha antagonists / inhibitors
5
I.g
Pulmonary fibrosis
2
Separation from RA-related pulmonary fibrosis can be extremely difficult (PMID 23791462)
Last update :
13/12/2013
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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
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Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Adalimumab
Etanercept
Golimumab
Infliximab
Publications
Tumor necrosis factor inhibitors and lung disease: a paradox of efficacy and risk.
Interstitial pneumonitis associated with infliximab therapy.