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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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Waterpipe (narghile, shisha) smoking
5
XV.bf
Path: Pulmonary necrotizing granuloma or granulomas
1
Last update :
21/10/2018
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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
Hookah smoking
Publications
Shisha smoking as a possible cause of bilateral granulomatous lung lesions.
A 20-year-old man with fever, chest pain, and lung nodules.