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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Anorexigens - Anorectic agents - Appetite suppressants

4

XII.b Valvular heart disease and/or dysfunction

3
Last update : 26/01/2013
 
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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
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Aminorex
5
Cannabinoids - Cannabinoid receptor agonists (synthetic) (K2, Spice)
5
Dexfenfluramine
3
Dinitrophenol (2, 4-dinitrophenol or DNP)
3
Fenfluramine
3
Levamisole
4
Mazindol
1
Phentermine
3
Thyroid hormones (exogenous)
1

Publications

Benfluorex and unexplained valvular heart disease: a case-control study.
PloS one 2010 Apr 12;5;e10128 2010 Apr 12
The longitudinal effects of fenfluramine-phentermine use.
Angiology 2007;58;353-9 2007
Quantitative analysis of human heart valves: does anorexigen exposure produce a distinctive morphological lesion?
Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology 2002;11;251-62 2002
Histologic changes in three explanted native cardiac valves following use of fenfluramines.
Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology 1999;8;245-53 1999
A population-based study of appetite-suppressant drugs and the risk of cardiac-valve regurgitation.
The New England journal of medicine 1998 Sep 10;339;719-24 1998 Sep 10
Appetite suppressants and valvular heart disease.
The New England journal of medicine 1998 Sep 10;339;765-6 1998 Sep 10
The prevalence of cardiac valvular insufficiency assessed by transthoracic echocardiography in obese patients treated with appetite-suppressant drugs.
The New England journal of medicine 1998 Sep 10;339;713-8 1998 Sep 10
Risk for valvular heart disease among users of fenfluramine and dexfenfluramine who underwent echocardiography before use of medication.
Annals of internal medicine 1998 Dec 01;129;870-4 1998 Dec 01
[Development of pulmonary hypertension and multi-valvular damage caused by appetite depressants].
Harefuah 1998 Dec 01;135;489-92, 568 1998 Dec 01

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