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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
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Methotrexate
5
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Rapidly progressive ILD/pulmonary fibrosis (Hamman-Rich syndrome)
1
Last update :
16/10/2012
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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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See also under
DMARDs (disease-modifying antirheumatic drugs)
Pemetrexed
Publications
Comment on methotrexate pneumonitis after initiation of infliximab therapy for rheumatoid arthritis.
Fatal pulmonary fibrosis complicating low dose methotrexate therapy for rheumatoid arthritis.