The Drug-Induced Respiratory Disease Website

Excipients, erroneously/deliberately administered i.v.

Path: Foreign body embolism, microangiopathy, vasculopathy

See PMID 34510050

Hossein-Zadeh Z, Shuman MJ, Rapkiewicz A

Fatal Excipients: An Autopsy Case Series of Excipient Lung Disease.

The American journal of forensic medicine and pathology 2022 Mar 01;43;81-89 — 2022 Mar 01 — 81-89

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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