The Drug-Induced Respiratory Disease Website

Cyanoacrylate

Eye-catcher: Cement (pulmonary) embolism

Intravascular densities. See also under VIh and under 'fluid mercury embolism'

Papiamonis NE, Matrella E, Blevrakis EG, Kouroumalis EA

Acute pulmonary embolism following -butyl-cyanoacrylate endoscopic injection sclerotherapy.

Annals of gastroenterology 2012;25;261 — 2012 — 261

Conway R, Aglan A, O'Connor E

Severe respiratory failure due to embolization of cyanoacrylate sclerosant.

QJM : monthly journal of the Association of Physicians 2014 Oct;107;831-2 — 2014 Oct — 831-2

Alexander S, Korman MG, Sievert W

Cyanoacrylate in the treatment of gastric varices complicated by multiple pulmonary emboli.

Internal medicine journal 2006 Jul;36;462-5 — 2006 Jul — 462-5

van Beek AP, van Erpecum KJ

Fatal N-butyl-2-cyanoacrylate pulmonary embolism after sclerotherapy for variceal bleeding.

Endoscopy 2005 Jul;37;687 — 2005 Jul — 687

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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