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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
Nitrosoureas (suffixes '-NU', '-mustine')
4
I.g
Pulmonary fibrosis
2
The fibrosis caused by nitrosoureas has the reputation for being severe, progressive and fatal
Last update :
31/12/2013
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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
Bendamustine
Carmustine (BCNU)
Fotemustine
Lomustine (CCNU)
Ranimustine
Semustine (methyl-CCNU)
Publications
BCNU for recurrent glioblastoma multiforme: efficacy, toxicity and prognostic factors.
Idiopathic pleuroparenchymal fibroelastosis: description of a novel clinicopathologic entity.
Pulmonary toxicity of lomustine.
Pulmonary fibrosis subsequent to high doses of CCNU for chronic myeloid leukemia.
Pulmonary fibrosis following low-dose 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU) therapy.
Nitrosourea-associated pulmonary fibrosis.
Fatal pulmonary fibrosis following 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) therapy.
Pulmonary fibrosis after prolonged therapy with 1,3-bis (2-chloroethyl)-1-nitrosourea.