The Drug-Induced Respiratory Disease Website

Methadone

Foreign body pulmonary vasculopathy (Excipient lung disease)

See also under Vv. Angiocentric foreign body granulomas may engulf talc, cellulose, starch, silica or crospovidone particles. For acrylate cement, see under under VIh. Review at PMID 23864061

Publications

Carson HJ, Feickert BL

Identification at autopsy of pulverized pills in lungs of a first-time methadone user.

Journal of forensic and legal medicine 2009 Nov;16;494-6 — 2009 Nov — 494-6

Tomashefski JF, Hirsch CS

The pulmonary vascular lesions of intravenous drug abuse.

Human pathology 1980 Mar;11;133-45 — 1980 Mar — 133-45

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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