The Drug-Induced Respiratory Disease Website

Acitretin

Capillary leak syndrome (CLS)

See also under Xr. Thoracic manifestations may include pulmonary edema, ARDS and pleural effusions (See also under IIa, IIb and Va). Review on causal circumstances and drug at PMID 30404164. Review in french at PMID 25600329

Publications

Vos LE, Vermeer MH, Pavel S

Acitretin induces capillary leak syndrome in a patient with pustular psoriasis.

Journal of the American Academy of Dermatology 2007 Feb;56;339-42 — 2007 Feb — 339-42

Estival JL, Dupin M, Kanitakis J, Combemale P

Capillary leak syndrome induced by acitretin.

The British journal of dermatology 2004 Jan;150;150-2 — 2004 Jan — 150-2

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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