The Drug-Induced Respiratory Disease Website

Anticoagulants, direct oral (anti-thrombin, -IIa, -Xa) - NOAC

Thoracic epidural or spinal hematoma

May cause spinal compression

Ismail R, Zaghrini E, Hitti E

Spontaneous Spinal Epidural Hematoma in a Patient on Rivaroxaban: Case Report and Literature Review.

The Journal of emergency medicine 2017 Oct;53;536-539 — 2017 Oct — 536-539

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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