Clinical and [123I]FP-CIT SPET imaging follow-up in patients with drug-induced parkinsonism

Drug-induced aseptic meningitis (DIAM) is a rare complication of certain drugs, most commonly reported with ibuprofen use. The present study reports on a male adolescent with intracranial hypertension and visual impairment accompanied by DIAM. We present a 16-year-old male patient who after ibuprofen consumption displayed headache, fever, photophobia, and blurred vision following heavy exercises. Examination of cerebrospinal fluid showed a mononuclear pleocytosis and an increase in protein concentration. Other examinations had normal results. The development of common clinical signs following ibuprofen use reflected DIAM. The patient’s vision was found to improve with supportive care and stopping of the drug during follow-up. Given the widespread use of nonsteroidal anti-inflammatory drugs and the fact that these drugs are the most common cause of DIAM, the probability of occurrence of this event should be always kept in mind, and screening for autoimmune diseases in these patients is of great importance.

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A case of statin-induced liver injury with positive rechallenge with a second statin. Is there a class effect?

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2021-0013 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Giovanna Onfiani ◽

Fabio Nascimbeni ◽

Francesca Carubbi

Keyword(s):

Liver Injury ◽

Clinical Symptoms ◽

High Risk Population ◽

Drug Induced ◽

Case Presentation ◽

Drug Induced Liver Injury ◽

Aged Woman ◽

Cardiovascular Morbidity And Mortality ◽

Middle Aged Woman

Abstract Objectives Statins have proved to reduce cardiovascular morbidity and mortality in high-risk population and are generally well tolerated, although adverse events can occur. Up to 3% of patients develop aminotransferases elevation, which usually normalizes with continued treatment and hardly is associated with clinical symptoms. Serious statin-related liver injury is exceedingly rare. Furthermore, literature regarding rechallenge with a second statin is extremely poor. Some authors caution that re-exposure to these drugs is associated with a more serious liver injury but safe switching to a second statin after drug-induced liver injury (DILI) is also reported. Case presentation We describe a case of a middle-aged woman who developed hepatocellular liver injury after simvastatin dose escalation; a rechallenge with low dose rosuvastatin caused rapid recurrence of DILI. Conclusions In our opinion, clinicians should be very cautious upon rechallenge and closely follow-up patients who experienced statin-induced liver injury when trying re-exposure to another statin.

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Co-existence of Rolandic and 3 Hz Spike-Wave Discharges on EEG in Children with Epilepsy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.364 ◽

2018 ◽

Vol 46 (1) ◽

pp. 64-70 ◽

Cited By ~ 3

Author(s):

Anita N. Datta ◽

Laura Wallbank ◽

Peter K. H. Wong

Keyword(s):

Clinical Data ◽

Seizure Control ◽

Age Of Onset ◽

Absence Epilepsy ◽

Childhood Absence Epilepsy ◽

Drug Induced ◽

Favorable Prognosis ◽

Spike Wave Discharges ◽

Spike Wave

AbstractObjectiveBenign epilepsy of childhood with central temporal spikes (BECTS) and absence epilepsy are common epilepsy syndromes in children with similar age of onset and favorable prognosis. However, the co-existence of the electrocardiogram (EEG) findings of rolandic spike and 3 Hz generalized spike-wave (GSW) discharges is extremely rare, with few cases reported in the literature. Our objective was to characterize the EEG findings of these syndromes in children in our center and review the electro-clinical features.MethodsAll EEGs at BC Children’s Hospital are entered in a database, which include EEG findings and clinical data. Patients with both centro-temporal spikes and 3 Hz GSW discharges were identified from the database and clinical data were reviewed.ResultsAmong the 43,061 patients in the database from 1992 to 2017, 1426 with isolated rolandic discharges and 528 patients with isolated 3 Hz GSW discharges were identified, and 20 (0.05%) patients had both findings: 3/20 had BECTS, and subsequently developed childhood absence epilepsy and 17/20 had no seizures characteristic for BECTS. At follow-up, 17 (85%) were seizure-free, 1 (5%) had rare, and 2 (10%) had frequent seizures.ConclusionsThis is the largest reported group of patients to our knowledge with the co-existence of rolandic and 3 Hz GSW discharges on EEGs in one institution, not drug-induced. As the presence of both findings is extremely rare, distinct pathophysiological mechanisms are likely. The majority had excellent seizure control at follow-up, similar to what would be expected for each type of epilepsy alone.

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Drug-Induced Leukoencephalopathy: MR Follow-Up After Corticosteroid Therapy

Imaging Gliomas After Treatment ◽

10.1007/978-3-030-31210-7_60 ◽

2019 ◽

pp. 269-269

Author(s):

Teresa Popolizio ◽

Nicola Sforza ◽

Rosario Francesco Balzano

Keyword(s):

Corticosteroid Therapy ◽

Drug Induced

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Kaleidoscope

The British Journal of Psychiatry ◽

10.1192/bjp.205.2.166 ◽

2014 ◽

Vol 205 (2) ◽

pp. 166-167 ◽

Cited By ~ 2

Author(s):

Derek K. Tracy ◽

Dan W. Joyce ◽

Sukhwinder S. Shergill

Keyword(s):

Violent Crime ◽

Population Based ◽

The Novel ◽

Drug Induced ◽

Persecutory Delusions ◽

Appropriate Treatment ◽

Cannabis Extract ◽

Drug Induced Psychosis ◽

The Uk

Drugs and violence are often observed as bedfellows; both have been associated with psychosis but the nature and timing of their relationships remains unclear. As part of the UK Prisoner Cohort Study, Keers et al prospectively followed up 967 prisoners convicted of sexual or violent offences (about a quarter of whom had a psychotic illness) in the community after release. Schizophrenia was associated with greater rates of violence, but the risk was mediated by untreated psychosis or when presenting with persecutory delusions – and no other definable psychopathology. Interestingly, drug-induced psychosis did not increase the risk of violence per se, once the substance misuse itself was accounted for. Does treatment have an impact on risk of violence in a population-based sample of patients with psychosis? Fazel et al demonstrated reductions in violent crime in patients during the time they were prescribed antipsychotics. Interestingly, the rates of violent crime were also reduced in patients with bipolar disorder who received mood stabilisers. Therefore, in addition to the effects of antipsychotics and mood stabilisers on relapse rates, their potential effects on violence and crime could be used to make decisions about management for these groups of patients. There is a clearer need for the appropriate treatment of prisoners with psychotic illnesses if their risk of violence is to be moderated. Cannabis is one of the most commonly used social drugs worldwide; it increases risk of psychosis, but there has been little to offer pharmacologically to those dependent upon this most prevalent illicit drug, and various trials of mood stabilisers, antidepressants and α2 adrenergic agonists have generally been disappointing. Allsop et al evaluated the novel cannabis extract nabiximols, containing cannabidiol – which has been shown to attenuate paranoia and euphoria – and tetrahydrocannabinol, delivered as a buccal spray. The active drug group showed statistically significant benefits in reduced withdrawal irritability, depression and cravings and remained longer in treatment. However, both placebo and drug groups showed reduced cannabis use at follow-up, with placebo being as effective as nabiximols in promoting longer-term cessation.

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Overlapping DRESS and Stevens-Johnson Syndrome: Case Report and Review of the Literature

Case Reports in Dermatology ◽

10.1159/000475802 ◽

2017 ◽

Vol 9 (2) ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Aneline Casagranda ◽

Mariano Suppa ◽

Florence Dehavay ◽

Véronique del Marmol

Keyword(s):

Diagnostic Criteria ◽

Adverse Reactions ◽

Stevens Johnson Syndrome ◽

Drug Induced ◽

Johnson Syndrome ◽

Systemic Symptoms ◽

The Right ◽

Exanthematous Pustulosis ◽

Cutaneous Adverse Reactions

Drug-induced severe cutaneous adverse reactions (SCARs) include acute generalized exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms (DRESS), and epidermal necrolysis (Stevens-Johnson syndrome [SJS], toxic epidermal necrolysis). The identification of the causal drug is crucial in order to avoid further exposure, but making the right differential diagnosis of the type of SCAR is equally important since treatment, follow-up, and prognosis of different SCARs are not the same. These syndromes are distinct entities with different clinical, biological, and histological patterns, but sometimes the early distinction between 2 SCARs can be extremely challenging, and overlapping conditions could therefore be taken into consideration, although true overlapping SCARs are very rare when using strict diagnostic criteria (described by the RegiSCAR group). Only a better understanding of the physiopathology of the SCARs could possibly explain these ambiguities and overlaps. We report a case of SCAR in an 86-year-old patient probably induced by allopurinol and simultaneously fulfilling the diagnostic criteria for DRESS and SJS, thus considered as an overlapping case of SCARs.

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A fifteen year follow-up study of tardive dyskinesia and drug induced Parkinsonism

European Neuropsychopharmacology ◽

10.1016/0924-977x(96)87911-9 ◽

1996 ◽

Vol 6 ◽

pp. 131-132

Author(s):

G. Gardos ◽

D.E. Casey ◽

A. Perenyi ◽

J.D. Cole ◽

E. Kocsis ◽

...

Keyword(s):

Tardive Dyskinesia ◽

Drug Induced ◽

Follow Up Study

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Clinical Course of Nonfunctional Pituitary Microadenoma in Children: A Single-Center Experience

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2019-01252 ◽

2019 ◽

Vol 104 (12) ◽

pp. 5906-5912 ◽

Cited By ~ 4

Author(s):

Vidhu V Thaker ◽

Adrianne E Lage ◽

Garima Kumari ◽

V Michelle Silvera ◽

Laurie E Cohen

Keyword(s):

Clinical Course ◽

Clinical Care ◽

Tertiary Care ◽

Drug Induced ◽

Health Records ◽

Clinical Data Warehouse ◽

Pituitary Microadenoma ◽

Single Center Experience

Abstract Context Pituitary lesions consistent with microadenomas are increasingly discovered by MRI. Sparse data are available on the long-term clinical and imaging course of such lesions in children. Objective The aim of this study was to define the clinical and imaging course of pituitary lesions representing or possibly representing nonfunctioning microadenomas in children to guide clinical management. Design Retrospective observational study. Methods The clinical data warehouse at a tertiary care academic children’s hospital was queried with the terms “pituitary” AND “microadenoma” and “pituitary” AND “incidentaloma.” The electronic health records of the identified subjects were reviewed to extract data on the clinical and imaging course. Results A total of 78 children had nonfunctioning pituitary lesions incidentally discovered during clinical care, of which 44 (56%) were reported as presumed or possible microadenomas. In the children with microadenoma (median age 15 years, interquartile range 2), a majority (70%) underwent imaging for nonendocrine symptoms, the most common being headache (n = 16, 36%). No significant increase in the size of the microadenoma or cysts or worsening of pituitary function was seen over the average clinical follow-up of 4.5 ± 2.6 years. Four cases of drug-induced hyperprolactinemia resolved with discontinuation of the offending medication. Conclusions Asymptomatic pituitary lesions representing cysts, microadenomas, or possible microadenomas follow a benign course in children. In the absence of new endocrine or visual symptoms, repeat MRI may not be needed, and if performed, should be done in no less than a year. When possible, it is prudent to discontinue hyperprolactinemia-inducing medications before imaging.

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