1/380. Lymphocyte transformation test for the evaluation of adverse effects of antituberculous drugs.The usefulness of the lymphocyte transformation test (LTT) for the analysis of adverse reactions to antituberculous drugs was evaluated. - The LTT was performed with isoniazid and rifampicin in 15 tuberculosis and 2 MOTT (Mycobacteria other than tuberculosis)-infection patients who suffered drug reactions, in 23 patients without any adverse reactions, in 7 controls previously exposed to antituberculous drugs, and in 14 controls who had never been exposed. 4/15 of the hepatotoxic reactions only showed a positive LTT with rifampicin, 3/15 only with isoniazid, and in 8/15 the LTT was negative. In an anaphylactoid shock reaction the LTT was extremely exaggerated for both rifampicin and isoniazid. In patients without any side effects only one slightly increased LTT due to isoniazid was observed. Two healthy controls with previous contact to these drugs showed a positive LTT for isoniazid, one of those with both rifampicin and isoniazid. The LTT was negative in all control persons without any former contact to antituberculous medications. In most cases hepatotoxicity seems to be a pure toxic reaction without the participation of cellular immune mechanisms. LTT can be useful for identifying the drug responsible for immunological side effects.- - - - - - - - - - ranking = 1keywords = drug (Clic here for more details about this article) |
2/380. Anaphylactic reaction to oral cefaclor in a child.Adverse drug reactions are a common clinical problem. It has been estimated that 6% to 15% of hospitalized patients experience some sort of adverse drug reaction. Clinical manifestations of adverse drug reactions include skin rash; a serum sickness-like reaction; drug fever; pulmonary, hepatic, and renal involvement; and systemic anaphylaxis. Many of these adverse events are not immunologically mediated. Actual allergic or immunologic drug reactions probably account for <25% of adverse drug reactions overall. Antibiotics are one of the major contributors to drug hypersensitivity. cefaclor, an oral second-generation cephalosporin with a beta-lactam ring, is used against various infectious diseases of the respiratory tract, especially in children. Several cases of cefaclor hypersensitivity have been reported. The most common presentations are either erythematous or papular eruptions, although serum sickness-like reactions have also been described. Anaphylactic reactions, although rare, have been observed in adults. Here we report a case of anaphylactic reaction to cefaclor in a 21/2-year-old patient.- - - - - - - - - - ranking = 0.77777777777778keywords = drug (Clic here for more details about this article) |
3/380. anaphylaxis from intraperitoneal infusion of cisplatin: a case report.Anaphylactic reactions to platinum compounds and paclitaxel are well-recognized complications during their systemic administration. Although there have been reports describing anaphylaxis during intravesical instillation of chemotherapeutic agents, to the best of the authors' knowledge, no hypersensitivity reactions after intraperitoneal administration of chemotherapeutic drugs has been reported in the English literature. The authors report an unusual case of anaphylaxis occurring in a 33-year-old woman who has been treated with paclitaxel and cisplatin for ovarian cancer. She developed a hypersensitivity reaction during her ninth cycle of chemotherapy, immediately after institution of intraperitoneal infusion of cisplatin. It is important to be aware of the possibility of anaphylaxis during chemotherapy administration other than the systemic route so that appropriate premedication or effective treatment can be promptly instituted.- - - - - - - - - - ranking = 0.11111111111111keywords = drug (Clic here for more details about this article) |
4/380. ceftizoxime-induced hemolysis due to immune complexes: case report and determination of the epitope responsible for immune complex-mediated hemolysis.BACKGROUND: Several occurrences of immune complex-mediated, cephalosporin-induced intravascular hemolysis have been reported. This report describes the first case of hemolytic anemia caused by an immune-complex mechanism associated with ceftizoxime and delineates the epitope responsible for hemolysis. CASE REPORT: The patient's serum was tested for antibody that reacted with five penicillins and 30 cephems (all types of cephalosporins) by using protocols to detect drug-adsorption and immune-complex mechanisms. The patient's antibody that formed immune complexes with ceftizoxime reacted with 10 of 30 cephems. These 10 drugs were classified as oxime-type cephalosporins, which have a common structural formula consisting of [(Z)-2-(2-amino-4-thiazolyl)-2-methoxyiminoacetoamido] at the C7 position on 7-aminocephalosporinic acid with or without substitution at the C3 position. CONCLUSION: The patient's antibody recognized a common structure in 10 oxime-type cephalosporins, and immune complexes formed by the antibody specifically or nonspecifically bound to red cell membranes. Therefore, when intermittent antibiotic therapy is required, as in this case, care should be taken in antibiotic selection to avoid drug-induced hemolytic anemia. In addition, when this type of hemolysis is observed, tests for antibody that reacts by adsorption and immune-complex mechanisms should be performed against penicillins and cephems to select antibiotics not showing a cross-reaction.- - - - - - - - - - ranking = 0.33333333333333keywords = drug (Clic here for more details about this article) |
5/380. Severe anaphylactic reaction after primary exposure to aprotinin.aprotinin is widely used to prevent bleeding and reduce blood transfusions after open heart surgical procedures. Because it is a foreign protein, aprotinin has allergenic potential. We report a case of near-fatal anaphylactic reaction to primary aprotinin exposure in a child successfully treated using cardiopulmonary bypass support. The possibility of an allergic reaction must be considered whenever this drug is used.- - - - - - - - - - ranking = 0.11111111111111keywords = drug (Clic here for more details about this article) |
6/380. Evidence of anaphylaxy after alteplase infusion.BACKGROUND AND PURPOSE: Although alteplase, a recombinant tissue plasminogen activator (tPA), is structurally identical to endogenous tPA and therefore should not induce allergy, single cases of acute hypersensitivity reactions have been reported. Until now, specific antibodies against alteplase were not detected in blood samples obtained in these patients. CASE DESCRIPTION: We report an anaphylactic reaction in a 70-year-old white female who was treated with intravenous alteplase for thrombolysis of acute ischemic stroke 160 minutes after onset of a right-sided hemiparesis. Thirty minutes after infusion of alteplase had been started, the patient suffered acute severe sinus tachycardia and hypotension, followed by cyanosis and loss of consciousness. The alteplase infusion was stopped, and following antiallergic therapy, tachycardia and hypotension resolved within 1 hour. The hemiparesis remained unaltered, but additional harm resulting from the hemodynamic complication was not observed. Serum samples analyzed with a radioimmunoprecipitation assay were negative for total antibodies to alteplase, but in a subsequent ELISA, both samples were positive for IgE antibodies to alteplase. CONCLUSIONS: The detection of specific IgE antibodies reactive with alteplase in this patient could provide the first evidence of an anaphylactic-type reaction to alteplase in man. Because previous exposure to alteplase can be excluded, the results suggest that this patient had preexisting antibodies that were cross-reactive with one or more epitopes of alteplase and therefore precipitated the anaphylactic-type reaction.- - - - - - - - - - ranking = 13.287159629725keywords = allergy (Clic here for more details about this article) |
7/380. Anaphylactic reaction secondary to a medication administration error in a patient receiving intravenous antibiotics.The occurrence of either medication administration errors or adverse drug reactions (ADRs) in hospitalized patients are well documented events. The combination of the two sequelae to drug therapies can lead to potentially life threatening episodes. In the case reported here, a medication administration error led to an ADR which threatened the life of a 12-month-old boy. The patient was receiving doses of cefotaxime sodium and nafcillin sodium, and was inadvertently administered a dose of cefoxitin sodium through a nursing staff medication administration errors. The patient experienced marked flushing; pitting edema, tachycardia, and a rapid respiration rate. Wheezing was absent. The patient recovered spontaneously after discontinuance of the inappropriately administered cefoxitin sodium dose, and discontinuance of cefotaxime sodium as well. pharmacists must remain diligent in the review of the drug use process in institutions. Appropriate reconstitution, labeling, and dispensing of prescribed IV medications does not necessarily lead to appropriate administration of the drug. pharmacy staff reviewal of the medication administration process must be carried out in conjunction with the nursing staff to ensure appropriate drug use. Patient and professional alike will benefit from such actions.- - - - - - - - - - ranking = 0.55555555555556keywords = drug (Clic here for more details about this article) |
8/380. Successful pregnancy in a woman with a human seminal plasma allergy. A case report.BACKGROUND: Human seminal plasma allergy is an anaphylaxis caused by immediate hypersensitivity to human seminal plasma. The utilization of a condom is usually recommended as the primary means of preventing an allergic reaction. infertility resulting from condom use, however, is an undesirable complication in many cases. Here we report on a successfully established pregnancy in a woman with seminal plasma allergy. CASE: A 29-year-old, married nulligravida with a human seminal plasma allergy consulted us to conceive. She showed a positive reaction to a skin-prick test with whole semen. In order to remove the seminal plasma, the sperm were washed three times using a continuous-step density gradient centrifugation method. Artificial insemination with the washed sperm was performed without anaphylactic symptoms. After six inseminations, pregnancy was achieved, and a healthy infant was delivered. CONCLUSION: Artificial insemination with sperm devoid of seminal plasma was very useful for establishing pregnancy in a woman with a human seminal plasma allergy.- - - - - - - - - - ranking = 106.2972770378keywords = allergy (Clic here for more details about this article) |
9/380. A study on severe food reactions in sweden--is soy protein an underestimated cause of food anaphylaxis?BACKGROUND AND methods: Because of a fatal case of soy anaphylaxis occurring in sweden in 1992, a study was started the following year in which all physicians were asked to report fatal and life-threatening reactions caused by food. The results of the first 3 years of the study are reported here, including results from another ongoing study on deaths from asthma during the same period. RESULTS: In 1993-6, 61 cases of severe reactions to food were reported, five of them fatal. Peanut, soy, and tree nuts seemed to have caused 45 of the 61 reactions, and four of them were fatal. If two cases occurring less than a year before our study started are included, we are aware of two deaths caused by peanuts and four deaths caused by soy. All four youngsters who died from soy anaphylaxis with asthma were severely allergic to peanuts but had no previously known allergy to soy. In most cases, there was a rather symptom-free period for 30-90 min between early mild symptoms and severe and rapidly deteriorating asthma. CONCLUSIONS: Soy has probably been underestimated as a cause of food anaphylaxis. Those at risk seem to be young people with asthma and peanut allergy so severe that they notice symptoms after indirect contact.- - - - - - - - - - ranking = 26.57431925945keywords = allergy (Clic here for more details about this article) |
10/380. Severe anaphylaxis after a chlorhexidine bath.anaphylaxis to chlorhexidine is rare. We report a patient who experienced anaphylaxis during a whole body bath with chlorhexidine. Early signs of a type I allergy may have been masked because of previous concomitant treatment with corticosteroids and PUVA.- - - - - - - - - - ranking = 13.287159629725keywords = allergy (Clic here for more details about this article) |
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