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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
Pyrethroid insecticides
1
Last update :
31/01/2021
I - Interstitial/parenchymal lung disease
I.af
Chemical (toxic) pneumonitis
1
II - Pulmonary edema - Acute lung injury - ARDS
II.b
ARDS - Acute lung injury
1
III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a
Alveolar hemorrhage (AH), diffuse AH (DAH)
1
XII - Cardiovascular involvement / toxicity
XII.s
Heart block (bundle branch- or AV-)
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
Meperfluthrin
Neonicotinoid insecticides
