The Drug-Induced Respiratory Disease Website

Nitric oxide (NO)

Pulmonary edema, noncardiogenic (NCPE)

Can be with normal or elevated pulmonary venous or pulmonary arterial wedge (occlusion) pressure (See PMID 23064842)

Baird JS, Havalad V, Aponte-Patel L, Ravindranath TM, October TW, Starc TJ, Smerling AJ

Nitric oxide-associated pulmonary edema in children with pulmonary venous hypertension.

Pediatric cardiology 2013 Apr;34;817-25 — 2013 Apr — 817-25

Preston IR, Klinger JR, Houtchens J, Nelson D, Mehta S, Hill NS

Pulmonary edema caused by inhaled nitric oxide therapy in two patients with pulmonary hypertension associated with the CREST syndrome.

Chest 2002 Feb;121;656-9 — 2002 Feb — 656-9

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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