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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
Breast implants - Augmentation mammaplasty (w/wo evidence for leakage/rupture)
4
XV.bn
Path: Silicone droplets/vacuoles in lung tissue, pulmonary vasculature, or lymph nodes
1
Last update :
13/02/2014
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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
Silicone, fluid
Publications
Silicone Lymphadenopathy after Rupture of Breast Implant.
Chronic Pulmonary Silicone Embolism Related to Saline Breast Implants.
Increasing pulmonary infiltrates in a 72-year-old woman with metastatic breast cancer.
Pneumonitis caused by silicone gel following breast implant rupture.
Silicone thorax due to a ruptured breast implant.
[Granulomatous pleurisy after mammaplasty, induced by polyacrylamide gel].