The Drug-Induced Respiratory Disease Website

Amiodarone

Airway pigmentation (black, bluish, petechial)

See: Lincoln, et al. Bronchial pigmentation as a manifestation of amiodarone pulmonary toxicity. J Bronchol 2007; 14: 275-7

Tunsupon P, Panchabhai TS, Khemasuwan D, Mehta AC

Black bronchoscopy.

Chest 2013 Nov;144;1696-1706 — 2013 Nov — 1696-1706

Küpeli E, Khemasuwan D, Lee P, Mehta AC

"Pills" and the air passages.

Chest 2013 Aug;144;651-660 — 2013 Aug — 651-660

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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