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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
IV.k
Bronchiectasis
1
When used orally in toddlers, oils may cause bronchiectasis later in life (PMID 7672066)
Last update :
25/02/2019
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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
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Clinical, imaging, BAL, pathological pattern consistent with the specific drug
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Careful exlusion of another cause
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Remission of symptoms with removal of drug
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Recurrence with rechallenge (rarely advisable)
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Causality assessment
More detailed checklist
See also under
Kerdane
Paraffin-Vaseline-Oil-Lipids (Mineral or other) p.o./inhaled/aspirated
Publications
Nasal or oral oil application on infants: a possible risk factor for adult bronchiectasis.
Kerosene pneumonitis treated with adrenal steroids.