The Drug-Induced Respiratory Disease Website

Cement implantation (bone cement, kyphoplasty, vertebroplasty)

Hemopericardium - Bloody pericardial effusion

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

D'Errico S, Niballi S, Bonuccelli D

Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty.

Journal of forensic and legal medicine 2019 Apr;63;48-51 — 2019 Apr — 48-51

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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