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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Busulfan

5

XV.i Path: Pneumocyte atypia (reactive epithelial cells) (a.k.a. the "Napoleon Hat" sign)

2
Last update : 02/10/2012
 
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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
More detailed checklist
See also under
Busulfan + Melphalan regimen
1

Publications

Drug-induced lung disease: a pragmatic classification incorporating HRCT appearances.
Seminars in respiratory and critical care medicine 2003 Aug;24;445-54 2003 Aug
Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 25-1997. A 60-year-old man with pulmonary infiltrates after a bone marrow transplantation.
The New England journal of medicine 1997 Aug 14;337;480-9 1997 Aug 14
Busulfan lung. Report of two cases and review of the literature.
The American journal of roentgenology, radium therapy, and nuclear medicine 1974 Jan;120;151-6 1974 Jan
Pulmonary lesions associated with busulfan therapy of chronic myelogenous leukemia.
Cancer 1971 May;27;1074-80 1971 May
Interstitial pulmonary fibrosis, atypical epithelial changes and bronchiolar cell carcinoma following busulfan therapy.
Cancer 1968 Nov;22;1027-32 1968 Nov
Busulphan lung.
Thorax 1968 Mar;23;187-93 1968 Mar

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