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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
XII.z
Heart valve thrombosis
Last update :
01/01/1970
Causative drugs
1
Dabigatran
I.a
I - Interstitial/parenchymal lung disease
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS)
I.b
I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD)
I.d
I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging)
III.a
III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH)
III.c
III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.c - Hemoptysis
III.h
III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.h - Major/massive hemoptysis
V.n
V - Pleural and/or pericardial involvement
V.n - Hemopericardium - Bloody pericardial effusion
XII.z
XII - Cardiovascular involvement / toxicity
XII.z - Heart valve thrombosis
XV.c
XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)
XVI.j
XVI - Imaging
XVI.j - Imaging: Wandering (migratory) pulmonary opacities
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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