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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
XII.bb
Endocardial fibroelastosis
Last update :
01/01/1970
Causative drugs
1
Doxorubicin - Adriamycin
I.d
I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging)
I.g
I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis
I.ad
I - Interstitial/parenchymal lung disease
I.ad - Radiation recall pneumonitis
II.b
II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury
XII.a
XII - Cardiovascular involvement / toxicity
XII.a - Left or biventricular dysfunction/failure
XII.f
XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic)
XII.l
XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)
XII.s
XII - Cardiovascular involvement / toxicity
XII.s - Heart block (bundle branch- or AV-)
XII.ai
XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity
XII.bb
XII - Cardiovascular involvement / toxicity
XII.bb - Endocardial fibroelastosis
XV.c
XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)
XXIV.j
XXIV - Veterinary medicine
XXIV.j - Veterinary: Cardiotoxicity
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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