The Drug-Induced Respiratory Disease Website

Ustekinumab

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

Hirschmann S, Fischer S, Klenske E, Dechant K, Distler JHW, Treutlein C, Neurath MF, Atreya R

Case report of severe constrictive perimyocarditis and ischemic hepatitis in a Crohn's disease patient upon infliximab-induced lupus-like syndrome.

Therapeutic advances in gastroenterology 2021;14;17562848211044033 — 2021 — 17562848211044033

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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