Acute dystonic reaction following treatment with a non-classic neuroleptic of the dibenzazepine-type

1987 ◽  
Vol 2 (5) ◽  
pp. 350-353
Author(s):  
E. Scholz ◽  
K. Mann ◽  
H.W. Schied ◽  
M. Bartels
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Cerebral Palsy ◽  
Clinical Signs ◽  
High Dose ◽  
Extrapyramidal Side Effects ◽  
Infantile Cerebral Palsy ◽  
Drug Induced ◽  
Dystonic Reaction ◽  
Acute Dystonia

SummaryExtrapyramidal side-effects with drug-induced parkinsonism have not previously been reported following treatment with the atypical dibenzazepine-type neuroleptics, clozapine and fluperlapine. We have however observed reversible acute dystonia in a patient following high-dose fluperlapine treatment. The clinical signs of a discrete infantile cerebral palsy observed in our patient are probably one of the risk factors. Although the differential diagnosis of acute dystonia as opposed to tardive dyskinesia was difficult, the patient's symptoms fit more closely the former. Pharmacological aspects of the observed movement disorder are discussed.

Subclinical Late Cardiomyopathy After Doxorubicin Therapy for Lymphoma in Adults

2004 ◽  
Vol 22 (10) ◽  
pp. 1864-1871 ◽  
Author(s):  
O. Hequet ◽  
Q.H. Le ◽  
I. Moullet ◽  
E. Pauli ◽  
G. Salles ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cumulative Dose ◽  
Hodgkin’S Lymphoma ◽  
Clinical Signs ◽  
Left Ventricular ◽  
Older Age ◽  
Hodgkin's Lymphoma ◽  
Smoking History ◽  
High Dose ◽  
Male Sex

Purpose To assess the cardiac status of the long-term survivors and to estimate the incidence and the features of subclinical cardiotoxicity induced after conventional treatment with doxorubicin for non-Hodgkin's lymphoma or Hodgkin's lymphoma. Patients and Methods We analyzed a group of patients who previously received doxorubicin-based chemotherapy for lymphoma. Echocardiograms were performed at least 5 years after therapy with anthracyclines. Clinical cardiomyopathy was defined by the presence of clinical signs of congestive heart failure (CHF). Subclinical cardiomyopathy was defined by decrease of left ventricular fractional shortening (FS) without clinical signs of CHF. Cumulative dose of doxorubicin, male sex, older age, relapse, radiotherapy (mediastinal or total-body irradiation), autologous stem-cell transplantation, high-dose cyclophosphamide, and cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia, familial history of cardiac disease, being overweight, and smoking history) were evaluated as potential risk factors for the development of cardiac dysfunction. Results Of 141 assessable patients (median age, 54 years; median cumulative dose of doxorubicin, 300 mg/m2), only one developed CHF. Criteria of subclinical cardiomyopathy were found in 39 patients. In multivariate analysis, factors that contributed to decreased FS were male sex (P < .01), older age (P < .01), higher cumulative dose of doxorubicin or association with another anthracycline (P = .04), radiotherapy (P = .04), and being overweight (P = .04). Conclusion Cardiac abnormalities can occur in patients treated with doxorubicin for lymphoma in the absence of CHF, even in patients who received moderate anthracycline doses. Male sex, older age, higher dose of doxorubicin, radiotherapy, and being overweight were risk factors for the development of cardiomyopathy.

scholarly journals Relevancia clínica del signo y síndrome de Chilaiditi, reporte de un caso

2019 ◽  
Vol 3 (2) ◽  
pp. 18
Author(s):  
Hipólito Guillermo Escobar Palma ◽  
Leonela Solange León Tapia
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Cerebral Palsy ◽  
Acute Abdomen ◽  
Radiological Finding ◽  
Imaging Studies ◽  
X Ray ◽  
Palabras Clave ◽  
Factores De Riesgo

  El signo de Chilaiditi es un hallazgo radiológico que se define como la interposición temporal o permanente de asas intestinales entre el hígado y el diafragma. Se denomina síndrome cuando se acompaña de sintomatología sugestiva de abdomen agudo. El signo y síndrome de Chilaiditi deben ser reconocidos con claridad por el pediatra clínico. Se reporta el caso de una paciente de 9 años de edad, producto de madre primigesta de 27 años. Al momento de la presunción diagnóstica debe tenerse en cuenta las patologías que forman parte del diagnóstico diferencial y asociar los estudios de imagen a la sintomatología y a los factores de riesgo que predisponen la aparición del síndrome de Chilaiditi. La incorrecta interpretación de signos, síntomas y de los estudios de imagenología, pueden conducir a establecer tratamientos inadecuados que no representan beneficios para el paciente.   Palabras clave: Signo de Chilaiditi, síndrome de Chilaiditi, parálisis cerebral, estreñimiento, radiografía de abdomen.   Abstract Chilaiditi´s sing is a radiological finding, defined as the temporary or permanent interposition of intestinal loops between liver and diaphragm. It is called a syndrome when it is accompanied by symptoms suggestive of acute abdomen. Chilaiditi´s sign and syndrome must be clearly recognized by the clinical pediatrician. The case of a 9-year-old patient, product of a 27-year-old mother, is reported. At moment of diagnostic presumption, it must take into account the pathologies that are part of the differential diagnosis, and associate the imaging studies with the symptoms and risk factors that predispose to the onset Chilaiditi´s syndrome. The incorrect interpretation of signs, symptoms and imaging studies can lead to inadequate treatments that do not represent benefits for the patient.   Keywords: Chilaiditi´s sing, Chilaiditi´s syndrome, cerebral palsy, constipation, abdominal X-ray.

scholarly journals Drug-Induced Atrial Fibrillation / Atrial Flutter

2022 ◽  
Vol 17 (6) ◽  
pp. 1-18
Author(s):  
O. D Ostroumova ◽  
M. S. Chernyaeva ◽  
A. I. Kochetkov ◽  
A. E. Vorobieva ◽  
D. I. Bakhteeva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Differential Diagnosis ◽  
Holter Monitoring ◽  
Clinical Situation ◽  
Drug Induced ◽  
Self Monitoring ◽  
Conduction Disturbances ◽  
Treatment And Prevention ◽  
Life Threatening

Drug-induced atrial fibrillation / flutter (DIAF) is a serious and potentially life-threatening complication of pharmacotherapy. Purpose of the work: systematization and analysis of scientific literature data on drugs, the use of which can cause the development of DIAF, as well as on epidemiology, pathophysiological mechanisms, risk factors, clinical picture, diagnosis and differential diagnosis, treatment and prevention of DIAF. Analysis of the literature has shown that many groups of drugs can cause the development of DIAF, with a greater frequency while taking anticancer drugs, drugs for the treatment of the cardiovascular, bronchopulmonary and central nervous systems. The mechanisms and main risk factors for the development of DIAF have not been finally established and are known only for certain drugs, therefore, this section requires further study. The main symptoms of DIAF are due to the severity of tachycardia and their influence on the parameters of central hemodynamics. For diagnosis, it is necessary to conduct an electrocardiogram (ECG) and Holter monitoring of an ECG and echocardiography. Differential diagnosis should be made with AF, which may be caused by other causes, as well as other rhythm and conduction disturbances. Successful treatment of DIAF is based on the principle of rapid recognition and immediate discontinuation of drugs (if possible), the use of which potentially caused the development of adverse drug reactions (ADR). The choice of management strategy: heart rate control or rhythm control, as well as the method of achievement (medication or non-medication), depends on the specific clinical situation. For the prevention of DIAF, it is necessary to instruct patients about possible symptoms and recommend self-monitoring of the pulse. It is important for practitioners to be wary of the risk of DIAF due to the variety of drugs that can potentially cause this ADR.

scholarly journals The ROLE OF VARIOUS RISK FACTORS IN THE DEVELOPMENT OF INFANTILE CEREBRAL PALSY

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
R. B. Issayeva ◽  
S.A. Abzaliyeva ◽  
G.T. Myrzabekova ◽  
R.J. Seysebaeva ◽  
D.A. Ospanova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Infantile Cerebral Palsy

scholarly journals Hypophysitis, the Growing Spectrum of a Rare Pituitary Disease

2021 ◽  
Author(s):  
Fabienne Langlois ◽  
Elena V Varlamov ◽  
Maria Fleseriu
Keyword(s):  
Differential Diagnosis ◽  
Pituitary Gland ◽  
Hormone Replacement ◽  
Mass Effect ◽  
High Dose ◽  
Drug Induced ◽  
Presumptive Diagnosis ◽  
Primary Tumors ◽  
Pituitary Dysfunction ◽  
Pituitary Disease

Abstract Hypophysitis is defined as inflammation of the pituitary gland that is primary or secondary to a local or systemic process. Differential diagnosis is broad (including primary tumors, metastases, and lympho-proliferative diseases) and multifaceted. Patients with hypophysitis typically present with headaches, some degree of anterior and/or posterior pituitary dysfunction, and enlargement of pituitary gland and/or stalk, as determined by imaging. Most hypophysitis causes are autoimmune, but other etiologies include inflammation secondary to cellar tumors or cysts, systemic diseases, and infection or drug-induced causes. Novel pathologies such as IgG4-related hypophysitis, immunotherapy-induced hypophysitis and paraneoplastic pituitary-directed autoimmunity are also included in a growing spectrum of this rare pituitary disease. Typical magnetic resonance imaging reveals stalk thickening and homogenous enlargement of the pituitary gland, however, imaging is not always specific. Diagnosis can be challenging and ultimately, only a pituitary biopsy can confirm hypophysitis type and rule out other etiologies. A presumptive diagnosis can be made often without biopsy. Detailed history and clinical examination are essential, notably for signs of underlying etiology with systemic manifestations. Hormone replacement and in selected cases careful observation is advised with imaging follow-up. High-dose glucocorticoids are initiated mainly to help reduce mass effect. A response may be observed in all auto-immune etiologies, but also in lymphoproliferative diseases, and as such should not be used for differential diagnosis. Surgery may be necessary in some cases to relieve mass effect and allow a definite diagnosis. Immunosuppressive therapy and radiation are sometimes also necessary in resistant cases.

scholarly journals Lung Injury Induced by Antitumor Drugs: Diagnosis, Features of the Clinical Course, Risk Factors, Differential Diagnosis, Treatment, and Prevention. Part 1

2021 ◽  
Vol 99 (7) ◽  
pp. 55-62
Author(s):  
N. V. Orlovа ◽  
O. D. Ostroumovа ◽  
E. V. Shikh ◽  
S. V. Smerdin ◽  
E. V. Rebrovа ◽  
...  
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Lung Injury ◽  
Tobacco Smoking ◽  
Clinical Course ◽  
Antitumor Drugs ◽  
Drug Induced ◽  
Duration Of Therapy ◽  
Treatment And Prevention

57 publications on pneumotoxicity of antitumor drugs were analyzed. It was found that the development of pneumotoxic effects could be influenced by risk factors such as gender, age, tobacco smoking, comorbidities, and duration of therapy. Symptoms of lung injury induced by antitumor drugs are nonspecific thus it is difficult to diagnose them promptly. For prevention, early diagnosis and timely management of drug-induced lung injury during antineoplastic therapy, it is necessary to raise awareness of such a condition in practitioners of different specialties, primarily general practitioners, pulmonologists, phthisiologists, and oncologists.

scholarly journals Sulfamethoxazole-induced sulfamethoxazole urolithiasis: a case report

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Megan M. Roedel ◽  
Stephen Y. Nakada ◽  
Kristina L. Penniston
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Urinary Calculi ◽  
Laser Lithotripsy ◽  
Stone Disease ◽  
High Dose ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Associated Risk Factors ◽  
Prevention Methods

Abstract Background Drug-induced urolithiasis falls into two categories: drug-induced and metabolically-induced. Certain antimicrobials are associated with each; sulfonamides are associated with drug- or metabolite-containing calculi when taken in large doses over a long period of time. Trimethoprim-sulfamethoxazole, a member of the sulfonamide family, is a rare cause of drug-induced calculi. Cases of sulfonamide urolithiasis occurring in patients with known stone disease have rarely been reported. Case presentation We report a case of a patient with a brief history of recurrent calcium oxalate nephrolithiasis requiring 2 ureteroscopic procedures whose existing 6 mm lower pole renal stone more than quadrupled in size to form a 4 cm renal staghorn after 4 months of high-dose treatment for Nocardia pneumonia with trimethoprim-sulfamethoxazole. After ureteroscopy with laser lithotripsy and basketing of fragments, the stone was found to be predominantly composed of N4-acetyl-sulfamethoxazole, a metabolite of sulfamethoxazole. Conclusion Stones composed of sulfamethoxazole or its metabolites are rare but have known associated risk factors that should be considered when prescribing this antibiotic. This case report illustrates additional risk factors for consideration, including pre-existing urinary calculi that may serve as a nidus for sulfamethoxazole deposition, and reviews treatment and prevention methods.

The clinical signs and risk factors of non-ambulatory children with cerebral palsy

2015 ◽  
Vol 09 (04) ◽  
pp. 447-454
Author(s):  
Bożena Okurowska-Zawada ◽  
Dorota Sienkiewicz ◽  
Grażyna Paszko-Patej ◽  
Elżbieta Gościk ◽  
Wojciech Kułak
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Clinical Signs ◽  
Children With Cerebral Palsy

Drug-Induced Movement Disorders in Institutionalised Adults with Mental Retardation: Clinical Characteristics and Risk Factors

1992 ◽  
Vol 26 (2) ◽  
pp. 242-248 ◽  
Author(s):  
Perminder Sachdev
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mental Retardation ◽  
Brain Damage ◽  
Movement Disorders ◽  
Clinical Characteristics ◽  
Extrapyramidal Side Effects ◽  
Drug Induced ◽  
Contentious Issue ◽  
History Of

Fifty-three institutionalised adults with mental retardation, the majority (73.5%) moderate to severe, were examined for drug-induced movement disorders. Using a global AIMS score of 2 or more, 16 (34%) of the 47 subjects who had been exposed to neuroleptics had tardive dyskinesia (TD). Three of these had developed the dyskinesia upon withdrawal of neuroleptics. The dyskinetic movements were mainly seen in the lingual, perioral and other facial muscles. Two (33%) out of 6 subjects with no history of exposure to neuroleptics also had similar dyskinetic movements. The total neuroleptic dose significantly, and age marginally, but not sex, brain damage or level of mental retardation, emerged as risk factors for TD. Two (3.7%) subjects had definite akathisia and 16 (30.8 %) significant extrapyramidal side effects. This study supports the findings of previous studies of considerable neurological adverse effects of neuroleptics in this patient group and cautions against their injudicious use. It provides further evidence for some putative risk factors for TD and is noteworthy for its lack of support for the contentious issue of brain damage as a risk factor.

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