The Drug-Induced Respiratory Disease Website

Immune checkpoint inhibitors (ICI) - ICI combinatorial Rx

Coagulopathy

May stem from thrombocytopenia or pancytopenia, DIC, drug-drug interaction with an vitamin K antagonist, or direct vitamin K antagonism. May lead to any pattern of bleeding under pattern family II

Publications

Eberst G, Lakhzoum W, Tomasini P, Andreotti N, Abcaya J, Mascaux C, Barlesi F

[Autoimmune-related bleeding occurring during combined immunotherapy for lung cancer - Case report].

Revue des maladies respiratoires 2018 Nov;35;974-977 — 2018 Nov — 974-977

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

Diagnosing DIRD

Identify causative drugs

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