The Drug-Induced Respiratory Disease Website

Infliximab

Myocarditis (can be fulminate/fulminant)

Typically acute. Can be fulminate/fulminant and fatal (PMID 30242316). General review at PMID 28540649. Recent addition to the lst of causal drugs include immune checkpoint inhibitors (PMID 28833116, 29801747)

Publications

Cesa K, Cunningham C, Harris T, Sunseri W

A Review of Extraintestinal Manifestations & Medication-Induced Myocarditis and Pericarditis in Pediatric Inflammatory Bowel Disease.

Cureus 2022 Jun;14;e26366 — 2022 Jun — e26366

Lezcano-Gort LE, Gómez-Barrado JJ, Mogollón-Jiménez MV, Garcipérez-de-Vargas-Díaz FJ

Hypersensitivity perimyocarditis after the first dose of infliximab.

Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva 2015 Apr;107;249 — 2015 Apr — 249

Slattery E, Ismail N, Sheridan J, Eustace K, Harewood G, Patchett S

Myocarditis associated with infliximab: a case report and review of the literature.

Inflammatory bowel diseases 2011 Jul;17;1633-4 — 2011 Jul — 1633-4

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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