The Drug-Induced Respiratory Disease Website

BCG therapy (topical instillations in the urinary bladder)

Guillain-Barré (or GB-like) syndrome (w/wo ARF)

ARF: acute resiratory failure

Webb K, Venkatesan P

Guillain Barré syndrome associated with bladder instillation of Bacille Calmette Guérin (BCG).

JMM case reports 2018 Aug;5;e005164 — 2018 Aug — e005164

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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