The Drug-Induced Respiratory Disease Website

CAR T-cell therapy

Coronary vasospasm - Vasospastic angina

Classically in the form of acute ST changes on EKG, acute coronary event or MI (See under XIIg). After episode, coronary bed/angiogram return to the patent state. May happen without preexisting/underlying CAD

Publications

Tao JJ, Roszkowska N, Majure DT, Mahmood SS

Coronary vasospasm during infusion of CD-19 directed chimeric antigen receptor T-cell therapy: a case report.

European heart journal. Case reports 2023 Aug;7;ytad342 — 2023 Aug — ytad342

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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