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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
Cosmetic talc
2
Last update :
10/06/2019
I - Interstitial/parenchymal lung disease
I.m
ILD with a granulomatous component
1
VII - Mediastinal involvement
VII.a
Lymphadenopathy (intrathoracic)
1
XV - Pathology
XV.e
Path: ILD with a granulomatous component (see also Im)
1
XV.q
Path: Foreign body deposits/granulomatous reaction
1
XV.da
Path: Birefringent particles in lung tissue and/or cells
2
XVI - Imaging
XVI.w
Imaging: Lung nodule or nodules
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
More detailed checklist
See also under
Talc (inhaled, sniffed, i.v., intrapleural)