The Drug-Induced Respiratory Disease Website

Phenytoin (diphenylhydantoin)

Imaging: Ground-glass opacities / GGO shadowing

Can be localized, disseminated or diffuse

Walker A, Rupal A, Jani C, Al Omari O, Singh H, Patel D, Perrino C, McCannon J

Longstanding Phenytoin Use as a Cause of Progressive Dyspnea.

Chest 2022 02;161;e91-e96 — 2022 02 — e91-e96

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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