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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
Corticosteroids, systemic (oral, parenteral)
5
II.a
Pulmonary edema, noncardiogenic (NCPE)
1
Only limited direct evidence available. May result from water and salt (sodium chloride) retention. Patients with underlying heart or valvular dysfunction at risk. Search for underlying heart failure indicated
Last update :
24/01/2019
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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
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Remission of symptoms with removal of drug
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Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Adrenocorticotropic hormone (ACTH)
Budesonide (p.o.)
Corticosteroids, inhaled (ICS)
Methylprednisolone
Prednisone
Salt (NaCl)
Publications
Fatal hypernatremia due to drinking a large quantity of shoyu (Japanese soy sauce).
Recurrent ARDS in a 39-year-old woman with migraine headaches.
Pulmonary complications and water retention in prolonged mechanical ventilation.