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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
Antiplatelet (-P2Y) agents
3
Last update :
21/09/2015
III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a
Alveolar hemorrhage (AH), diffuse AH (DAH)
1
IV - Airway involvement
IV.r
Airway pigmentation (black, bluish, petechial)
1
VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.q
Tongue involvement (edema, glossitis, hematoma)
1
IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.h
Dyspnea, unexplained otherwise
3
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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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Ticagrelor