1/794. Unusual evidence of myocardial involvement during a hypersensitivity reaction to oral penicillin.A hypersensitivity reaction to orally administered phenoxymethyl penicillin is reported. The manifestations of the reaction included fever, arthralgia, urticaria and an irregular pulse. Serial ECG showed second-degree atrioventricular block with junctional escape beats, an atypical Wenckebach pattern and, finally, first-degree atrioventricular block with gradually decreasing PR intervals. A normal tracing was recorded on the sixth day despite the persistence of the rash and joint pains.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
2/794. hypersensitivity reactions to intraperitoneal administration of carboplatin in ovarian cancer: the first report of a case.hypersensitivity reactions to intravenous administration of carboplatin (CP) have been previously reported. However, hypersensitivity reaction to intraperitoneal administration of CP has not yet been reported. A 66-year-old woman diagnosed with ovarian carcinoma underwent six courses of intraperitoneal administration of carboplatin. During the seventh course of chemotherapy, delivered intraperitoneally, she developed hypersensitivity reactions with hypotension to carboplatin. etoposide was used for the further chemotherapy. To the best of our knowledge, this is the first case report of hypersensitivity reactions to intraperitoneal administration of carboplatin.- - - - - - - - - - ranking = 1.6keywords = sensitivity (Clic here for more details about this article) |
3/794. 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 = 1.4241189387588keywords = contact (Clic here for more details about this article) |
4/794. cholestasis and liver cell damage due to hypersensitivity to erythromycin stearate--recurrence following therapy with erythromycin succinate.erythromycin is a frequently used antibiotic in patients with atypical respiratory infection and/or an allergy to penicillin. We report the case of a young woman who developed severe cholestasis and jaundice following treatment with erythromycin stearate. Two years later her general practitioner prescribed erythromycin succinate for pharyngitis. She experienced a severe second episode of jaundice and malaise. Different esters of erythromycin have been introduced to reduce side effects such as allergic reactions to erythromycin. The findings in our patient underline the fact that hypersensitivity is caused by the erythromycin molecule, independent from the type of esterification. Because of these side effects newer makrolides should be given preference over erythromycin.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
5/794. Allergic reactions to lignocaine.True allergic reactions to local analgesics are extremely rare. This case report illustrates the procedures adopted to manage a patient with a history of suspected allergy. A young woman was found to have a true type I hypersensitivity to lignocaine. Another routinely used local analgesic agent, prilocaine, was tested by the same methods and found to give no allergic response. Dental treatment was successfully completed using the latter and the patient advised to wear a medical alert bracelet.- - - - - - - - - - ranking = 0.2keywords = sensitivity (Clic here for more details about this article) |
6/794. Anticonvulsant hypersensitivity syndrome occurring as sepsis with multiorgan dysfunction.phenytoin is a highly effective and widely prescribed anticonvulsant agent. However, it is associated with both dose-related side effects and hypersensitivity reactions. life-threatening anticonvulsant hypersensitivity syndrome in one patient was characterized by a skin eruption and multisystem organ dysfunction.- - - - - - - - - - ranking = 1.2keywords = sensitivity (Clic here for more details about this article) |
7/794. Continued therapy with hiv-1 protease inhibitors, despite previous hypersensitivity reactions, through coadministration of prednisone.We describe an hiv-1 positive patient who developed severe hypersensitivity reactions during treatment with each of the three currently available protease inhibitors. Addition of prednisone enabled continued use of saquinavir, one of these protease inhibitors, thereby achieving a degree of viral suppression which otherwise would not have been possible.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
8/794. 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 = 0.2keywords = sensitivity (Clic here for more details about this article) |
9/794. Allergic-type reactions to corticosteroids.OBJECTIVE: To review reported cases of suspected allergic reactions to various corticosteroids. DATA SOURCES: A medline search (January 1966-December 1997) was performed to obtain case reports and review articles on allergic-type reactions to corticosteroids. Further references were obtained from these publications. STUDY SELECTION: Reports involving allergic or allergic-type reactions to systemic administration of corticosteroids were chosen for this review. An allergic-type reaction was defined as any reaction after administration of the drug that involved the appearance of adverse symptoms that are characteristic of unwanted immune responses. These symptoms include rash, sneezing, dyspnea, edema, bronchospasm, or death. Articles were excluded from the evaluation if they described reactions to topical, intraarticular, or ophthalmic corticosteroid administration. DATA SYNTHESIS: Corticosteroids are medications that are often used to treat allergic reactions. However, it appears that patients can also have allergic-type reactions to these agents. The severity of the reaction can vary from a rash to anaphylaxis or death. Both immediate and delayed reactions can occur. Allergic-type reactions are reported to occur more frequently in asthmatic and renal transplant patients than other patient populations. However, it is questionable whether all of these are true allergic responses, as there is conflicting evidence regarding the mechanism of the reaction. The most commonly implicated corticosteroids are methylprednisolone and hydrocortisone, but reactions have also occurred with others. Intradermal skin testing can help determine cross-sensitivity, although its value has not been conclusively demonstrated. CONCLUSIONS: Clinicians should be aware that allergic reactions to corticosteroids are possible. Worsening of symptoms may not always mean treatment failure, but may indicate an allergic reaction. High doses of corticosteroids (> or = 500 mg) should be given over 30-60 minutes, and patients should be observed after administration for at least the same time period. Asthmatics, renal transplant patients, and hemodynamically unstable patients may be at higher risk for adverse events. If a patient is found to be allergic to one corticosteroid, intradermal skin testing may help identify another corticosteroid that can be tolerated.- - - - - - - - - - ranking = 0.2keywords = sensitivity (Clic here for more details about this article) |
10/794. Cross-sensitivity and the anticonvulsant hypersensitivity syndrome.The anticonvulsant hypersensitivity syndrome is a rare complication that occurs with the use of antiepileptic medications. Although phenytoin is the most common culprit, carbamazepine and phenobarbital are known to cause a similar reaction. A familial occurrence has been reported. We present a case of the anticonvulsant hypersensitivity syndrome to emphasize the importance of recognizing the multiple clinical components of the syndrome and to raise awareness of the cross-sensitivity among anticonvulsants metabolized via arene oxide metabolites.- - - - - - - - - - ranking = 2.2keywords = sensitivity (Clic here for more details about this article) |
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