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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
X.al
Drug withdrawal syndrome
Clinical presentation may vary with drug. May manifest with an ARDS picture
Last update :
01/01/1970
Causative drugs
1
Ruxolitinib
I.a
I - Interstitial/parenchymal lung disease
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS)
II.b
II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury
V.a
V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs)
VI.b
VI - Pulmonary vasculopathies
VI.b - Pulmonary arterial hypertension
IX.h
IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.h - Dyspnea, unexplained otherwise
X.n
X - Systemic/Distant conditions, syndromes and reactions
X.n - Tumor lysis syndrome (TLS)
X.al
X - Systemic/Distant conditions, syndromes and reactions
X.al - Drug withdrawal syndrome
XI.d
XI - Miscellaneous
XI.d - Metabolic acidosis (incl. lactic acidosis/-gap). May cause hyperpnea/dyspnea
XVII.b
XVII - Infections & related conditions
XVII.b - Opportunistic pulmonary/systemic infections
XVII.e
XVII - Infections & related conditions
XVII.e - Pneumocystis jiroveci pneumonia
XVII.g
XVII - Infections & related conditions
XVII.g - Tuberculosis (pulmonary, pulmonary, extrapulmonary or disseminated). Reactivation or de novo
XVII.y
XVII - Infections & related conditions
XVII.y - Cryptococcus pulmonary and/or systemic infection
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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