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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
XVIII.e
Eye-catcher: Multiple radiolucent balls
Last update :
01/01/1970
Causative drugs
2
Collapse therapy
XVIII.e
XVIII - Distinctive patterns - 'Eye-catchers'
XVIII.e - Eye-catcher: Multiple radiolucent balls
2
Status post-thoracic/cardiovascular surgery
I.y
I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis
V.a
V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs)
V.c
V - Pleural and/or pericardial involvement
V.c - Pleural thickening
V.f
V - Pleural and/or pericardial involvement
V.f - Pneumothorax
V.h
V - Pleural and/or pericardial involvement
V.h - Chylothorax
VII.i
VII - Mediastinal involvement
VII.i - Mediastinitis
X.k
X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic)
XII.k
XII - Cardiovascular involvement / toxicity
XII.k - Constrictive pericarditis - Pericardial thickening
XVIII.e
XVIII - Distinctive patterns - 'Eye-catchers'
XVIII.e - Eye-catcher: Multiple radiolucent balls
1
1
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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
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