The Drug-Induced Respiratory Disease Website

Anticoagulants, oral (vitamin K antagonists-VKA)

Calcification of tracheobronchial cartilaginous rings

(Fr: calcifications des anneaux cartilagineux trachéo-bronchiques)

Jo SH, Choi YJ, Cho GY, Kim HS, Jung KS, Rhim CY

Tracheal calcification.

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 2008 Jul 29;179;291 — 2008 Jul 29 — 291

Joshi A, Berdon WE, Ruzal-Shapiro C, Barst RJ

CT detection of tracheobronchial calcification in an 18-year-old on maintenance warfarin sodium therapy: cause and effect?

AJR. American journal of roentgenology 2000 Sep;175;921-2 — 2000 Sep — 921-2

Moncada RM, Venta LA, Venta ER, Fareed J, Walenga JM, Messmore HL

Tracheal and bronchial cartilaginous rings: warfarin sodium-induced calcification.

Radiology 1992 Aug;184;437-9 — 1992 Aug — 437-9

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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