The Drug-Induced Respiratory Disease Website

Sunitinib

In renal cell carcinoma patients on sunitinib, separation of ILD or DAH from pulmonary metastatic disease can be exceedingly difficult (PMID 19289369)

II - Myocardial dysfunction - Heart failure

II.a

Left ventricular dysfunction/failure

II.c

Heart failure (biventricular, congestive)

XIV - Pleural involvement

XIV.a

Pleural effusion (uni or bilateral) (can accompany ILD induced by the drug)

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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