The Drug-Induced Respiratory Disease Website

Acupuncture

Hemopericardium - Bloody pericardial effusion

Large effusions can cause cardiac tamponade. May occur late into treatment with anticoagulants

Her AY, Kim YH, Ryu SM, Cho JH

Cardiac tamponade complicated by acupuncture: hemopericardium due to shredded coronary artery injury.

Yonsei medical journal 2013 May 01;54;788-90 — 2013 May 01 — 788-90

Kim JH, Kim SH, Lee YJ, Hong JS, Ahn R, Hong ES

Hemopericardium following acupuncture.

Yonsei medical journal 2011 Jan;52;207-9 — 2011 Jan — 207-9

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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