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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
Radiation therapy to the chest
5
XV.i
Path: Pneumocyte atypia (reactive epithelial cells) (a.k.a. the "Napoleon Hat" sign)
2
Last update :
24/01/2013
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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
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Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
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See also under
Radiation therapy (early effects)
Radiation therapy (endobronchial brachytherapy)
Radiation therapy (medium term & late effects)
Radiation therapy to the breast
Radiation therapy, infusional (injected 131I or 90Y radioactivity)
Radiation therapy, mantle-field-
Radiation therapy, stereotactic (SBRT)
Radioactive seeds
Publications
Low-dose radiation pneumonitis.
Bilateral radiation pneumonitis after unilateral lung and mediastinal irradiation.