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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
Lorlatinib
1
Last update :
11/03/2018
I - Interstitial/parenchymal lung disease
I.a
Pneumonitis (ILD), acute and/or severe (may cause ARDS)
1
I.b
Pneumonitis (ILD)
1
I.ad
Radiation recall pneumonitis
1
II - Pulmonary edema - Acute lung injury - ARDS
II.b
ARDS - Acute lung injury
1
VI - Pulmonary vasculopathies
VI.b
Pulmonary arterial hypertension
1
IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.r
Myasthenia gravis - Myasthenic-like syndrome
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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