The Drug-Induced Respiratory Disease Website

Busulfan

Acute lung injury - ARDS

Following high-dose busulfan or as a terminal event in previously indolent busulfan lung

Bilgrami SF, Metersky ML, McNally D, Naqvi BH, Kapur D, Raible D, Bona RD, Edwards RL, Feingold JM, Clive JM, Tutschka PJ

Idiopathic pneumonia syndrome following myeloablative chemotherapy and autologous transplantation.

The Annals of pharmacotherapy 2001 Feb;35;196-201 — 2001 Feb — 196-201

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

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