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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
XV.cf
Path: Myocardial fibrosis
Last update :
01/01/1970
Causative drugs
1
Amitriptyline
I.c
I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)
II.b
II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury
IX.d
IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.d - Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)
X.a
X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction
XII.c
XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade)
XII.d
XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant)
XV.ca
XV - Pathology
XV.ca - Path: Myocarditis
XV.cf
XV - Pathology
XV.cf - Path: Myocardial fibrosis
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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