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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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Radiation therapy (medium term & late effects)
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Chylothorax
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Last update :
15/04/2012
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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
More detailed checklist
See also under
Radiation therapy (early effects)
Radiation therapy to the breast
Radiation therapy to the chest
Radiation therapy, infusional (injected 131I or 90Y radioactivity)
Radiation therapy, mantle-field-
Radiation therapy, stereotactic (SBRT)
Publications
Etiology of chylothorax in 203 patients.
Chylothorax occurring 23 years post-irradiation: literature review and management strategies.
Chylothorax from radiation-induced mediastinal fibrosis.
Chylothorax: the result of previous radiation therapy?
Delayed chylothorax after irradiation.
Chylothorax and pleural effusion as late complications of thoracic irradiation.
Thoracoscopic ligation of a thoracic duct leakage.
Chylothorax after mantle field irradiation for Hodgkin's disease.