1/3. Montelukast-induced generalized urticaria.OBJECTIVE: To report a case of generalized urticaria induced by montelukast treatment. CASE SUMMARY: A 28-year-old man with allergic rhinitis and moderate persistent asthma developed generalized urticaria 5 days after the initiation of montelukast and inhaled fluticasone. Symptoms disappeared within one day after suspension of both drugs. Two months later, after the resumption of montelukast and fluticasone, the patient developed generalized urticaria and eyelid angioedema, which were successfully treated with intravenous betamethasone, achieving complete remission within hours. After 2 days, the patient resumed inhaled fluticasone only and continued this therapy for several months without any adverse reaction. DISCUSSION: We attributed the adverse reaction to montelukast because of the temporal relationship between use of montelukast and urticaria, the absence of other identified causative factors and other explanations for allergic reactions, and the positive dechallenge and rechallenge. The Naranjo probability scale showed a probable relationship between skin manifestations and montelukast treatment. CONCLUSIONS: The use of antileukotrienes is increasing in asthma therapy. In cases of generalized urticaria in asthmatic patients undergoing montelukast therapy, physicians should be aware of a potential adverse reaction to this drug.- - - - - - - - - - ranking = 1keywords = probability (Clic here for more details about this article) |
2/3. Chronic urticaria due to dental eugenol.A case is reported of a patient with chronic urticaria. The correlation between the symptoms and dental treatment gave rise to the supposition that a root canal cement was causing the trouble. A causal relationship with eugenol, a cement constituent, could only be established through provocative oral ingestion. There is a high probability that the oral provocation tests to eugenol are relevant. Nevertheless, caution is needed when dealing with chronic urticaria.- - - - - - - - - - ranking = 1keywords = probability (Clic here for more details about this article) |
3/3. The use of antithymocyte globulin in the treatment of severe aplastic anemia in children.The benefit of antithymocyte globulin in severe aplastic anemia in the pediatric age group was assessed. Four children received ten alternate-day courses of ATG (horse antihuman thymocyte globulin) as well as antihistamines and corticosteroids to minimize allergic reactions. The outcome of 19 other children with severe aplastic anemia who received ATG was also summarized. Combined data reveal that 12 of 23 have had a complete or partial response with residual thrombocytopenia and a probability of 48% survival one year from the start of ATG therapy as projected by life table analysis. Only one death has been recorded in the responding group. Response rate did not appear to be influenced by age, sex, etiology, initial blood count, interval prior to ATG therapy, or dose of ATG employed. Complications were minimal and included minor urticarial reactions and intermittent fever. Therapy with ATG should be considered in childhood severe aplastic anemia when bone marrow transplantation is not possible.- - - - - - - - - - ranking = 1keywords = probability (Clic here for more details about this article) |