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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
Levamisole-adulterated/tainted cocaine
5
XI.n
Neutropenia, agranulocytosis (w/wo infection/sepsis)
3
Last update :
22/09/2015
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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
Abused drugs/substances (illicit-, street drugs - IV/inhaled)
Aminorex
Cocaine
Crack cocaine
Levamisole
Publications
Recurrent Levamisole-Induced Agranulocytosis Complicated by Bowel Ischemia in a Cocaine User.
Cocaine/levamisole-associated autoimmune syndrome: a disease of neutrophil-mediated autoimmunity.
Levamisole tainted cocaine: an emerging health issue.
Levamisole-contaminated cocaine: an emergent cause of vasculitis and skin necrosis.
Levamisole exposure and hematologic indices in cocaine users.