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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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XII.ao
Intracardiac bone cement embolism
Last update :
01/01/1970
Causative drugs
1
Cement (bone cement, kyphoplasty, vertebroplasty)
II.b
II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury
V.n
V - Pleural and/or pericardial involvement
V.n - Hemopericardium - Bloody pericardial effusion
VI.e
VI - Pulmonary vasculopathies
VI.e - Fat/oil embolism - The FES embolism syndrome
VI.h
VI - Pulmonary vasculopathies
VI.h - Cement embolism
VI.t
VI - Pulmonary vasculopathies
VI.t - Pulmonary artery aneurysm(s)
VI.v
VI - Pulmonary vasculopathies
VI.v - Foreign body/substance pulmonary embolism
X.f
X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal)
XII.ao
XII - Cardiovascular involvement / toxicity
XII.ao - Intracardiac bone cement embolism
XII.bd
XII - Cardiovascular involvement / toxicity
XII.bd - Perforation of the heart - Cardiac rupture
XV.ae
XV - Pathology
XV.ae - Path: Lipid/fat embolism (see also VIe)
XV.ai
XV - Pathology
XV.ai - Path: Acrylate bone cement pulmonary embolism
XVI.ax
XVI - Imaging
XVI.ax - Imaging: Foreign body pulmonary embolism
XVIII.g
XVIII - Distinctive patterns - 'Eye-catchers'
XVIII.g - Eye-catcher: Cement (pulmonary) embolism
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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