Pneumotox » Drug » Diacetyl (2,3-butanedione) flavoring agent

Diacetyl (2,3-butanedione) flavoring agent

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A flavoring agent used in food processing. Can cause obliterative bronchiolitis in man. This has received experimental support in laboratory animals. This compound may be contained in e-cigarette smoke/vapor. Pentanedione may expose to similar risks. PMID 26761629

Last update : 27/06/2021

IV.c Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx)

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IV.n Obstructive airway dysfunction (see also IVc, XVx)

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XV.x Path: Acute/subacute bronchiolitis (see also IVc, IVi)

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XV.z Path: Obliterative (constrictive) bronchiolitis (see also IVc, IVn)

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XV.cv Path: Peribronchiolar granulomas

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Diagnosing DIRD

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Drug and radiation history

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Drug singularity - Correct identification of the drug

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Consistent timing of exposure v. onset of symptoms

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Clinical, imaging, BAL, pathological pattern consistent with the specific drug

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Careful exlusion of another cause

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Remission of symptoms with removal of drug

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Recurrence with rechallenge (rarely advisable)

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Causality assessment

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