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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
Hydrocarbons (petrochemicals: petroleum, petrolatum, paraffin, vaseline, naphta, jet fuel (kerosene), Diesel, gasoil), ointments, salad oil, variegated oils, butter). Aspirated
5
XVI.ab
Imaging: Cavitating/cavitary lung nodule, mass or nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)
2
Last update :
30/12/2013
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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
Kerdane
Paraffin-Vaseline-Oil-Lipids (Mineral or other) p.o./inhaled/aspirated
Publications
Acute exogenous lipoid pneumonia: Unusual presentation as cavitating lung disease with pneumothorax.
Turpentine oil inhalation leading to lung necrosis and empyema in a toddler.
Acute hydrocarbon pneumonia after white spirit aspiration: sequential HRCT findings.