The Drug-Induced Respiratory Disease Website

Tobramycin (nebulized, inhaled)

Anti-GBM antibody disease (Goodpasture-like or flare of preexisting GS)

GBM for antiglomerular basement membrane

Inoue C, Hagiya H

Anti-Glomerular Basement Membrane Nephritis Potentially Induced by Nebulized Tobramycin Inhalation.

Journal of aerosol medicine and pulmonary drug delivery 2021 Dec 03;; — 2021 Dec 03

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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