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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
XVIII.a
Eye catcher: Contrast tracheo-bronchogram
Last update :
01/01/1970
Causative drugs
1
Barium (baryum, Ba) sulfate contrast agent
IX.a
IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.a - Diaphragm/inspiratory muscle weakness/paralysis (w/wo ARF)
XV.ar
XV - Pathology
XV.ar - Path: Barium lung
XVI.n
XVI - Imaging
XVI.n - Imaging: Intralobular septal thickening - Crazy paving
XVI.am
XVI - Imaging
XVI.am - Imaging: Contrast tracheo- and/or bronchogram
XVII.a
XVII - Infections & related conditions
XVII.a - Respiratory tract infection incl. pneumonia
XVIII.a
XVIII - Distinctive patterns - 'Eye-catchers'
XVIII.a - Eye catcher: Contrast tracheo-bronchogram
XVIII.v
XVIII - Distinctive patterns - 'Eye-catchers'
XVIII.v - Eye catcher: Lung (micro)nodules showing metallic density/attenuation
1
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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