The Drug-Induced Respiratory Disease Website

BCG therapy (topical instillations in the urinary bladder)

Myasthenia gravis - Myasthenic-like syndrome

May ccause ARF. See also under respiratory muscle weakness

Takizawa T, Kojima M, Suzuki S, Osada T, Kitagawa S, Nakahara J, Takahashi S, Suzuki N

New onset of myasthenia gravis after intravesical Bacillus Calmette-Guerin: A case report and literature review.

Medicine 2017 Nov;96;e8757 — 2017 Nov — e8757

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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