scholarly journals Amiodarone-induced diffuse alveolar haemorrhage: a rare but potentially life-threatening complication of a commonly prescribed medication

2019 ◽  
Vol 12 (10) ◽  
pp. e232149 ◽  
Author(s):  
Jamaluddin Saeed ◽  
Qazi Ahmed Waqas ◽  
Uzma Ikhtiar Khan ◽  
Hafez Mohammad Ammar Abdullah
Keyword(s):  
Clinical Practice ◽  
Side Effects ◽  
Antiarrhythmic Agent ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Shortness Of Breath ◽  
Pulmonary Manifestations ◽  
Oral Steroids ◽  
Life Threatening ◽  
Life Threatening Complication

Amiodarone is an antiarrhythmic agent that is used commonly in clinical practice. It is associated with many side effects, the most common being pulmonary manifestations. Interstitial pneumonitis is one of the most common complications, however rarely amiodarone can cause diffuse alveolar haemorrhage (DAH) too. We describe the case of a 73-year-old woman who presented with shortness of breath and haemoptysis 4 days after starting amiodarone. She was diagnosed with amiodarone-induced DAH based on imaging and bronchoalveolar lavage. She was treated with intravenous and then oral steroids, and amiodarone was discontinued. The patient made a significant clinical and radiological recovery. She was discharged 10 days after her presentation. This case highlights a rare but potentially life-threatening complication of a commonly used medication.

Delirium on clozapine: A tale of friend turned foe-A case report

2020 ◽  
pp. 009121742097282 ◽  
Author(s):  
Aparna Das ◽  
Rebecca Minner ◽  
Lewis Krain ◽  
John Spollen
Keyword(s):  
Case Report ◽  
Clinical Practice ◽  
Side Effects ◽  
Adverse Effects ◽  
Older Adult ◽  
Psychiatric Illness ◽  
Management Strategies ◽  
Treatment Resistant ◽  
Drug Of Choice ◽  
Life Threatening

Treatment resistant schizophrenia (TRS) is often encountered in clinical practice. Clozapine remains the drug of choice in the management of TRS. Several studies have shown that clozapine is the most effective antipsychotic medication to date for TRS. But it is also well known that it has multiple side effects. Some side effects are transient and relatively benign, while other adverse effects are menacing, serious and life-threatening. Delirium may occur with clozapine and is a therapeutic challenge as there is always a risk of precipitating delirium on clozapine rechallenge. Limited management strategies are available as alternatives for the management of psychiatric illness stabilized on clozapine. In this case report, we describe an older adult patient who developed delirium on clozapine. The aims of this case report are to discuss the mechanism by which clozapine leads to delirium, revisit various factors which could possibly lead to delirium, and discuss the different management strategies available for management of psychiatric illness for a patient previously stabilized on clozapine.

Risperidone-Induced Neuroleptic Malignant Syndrome: A Case Report and Review

1996 ◽  
Vol 41 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Gb Meterissian
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Neuroleptic Malignant Syndrome ◽  
Clinical Features ◽  
Prior History ◽  
Extrapyramidal Side Effects ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication ◽  
The One

Objectives: 1. To report the case of a 53-year-old patient who developed neuroleptic malignant syndrome (NMS) — a rare but potentially life-threatening complication of neuroleptic therapy — 4 days after treatment with risperidone was initiated. 2. To review previously reported cases of NMS associated with risperidone. Methods: A computerized search of several databases, including MEDLINE, was conducted to find all previously reported cases of NMS with risperidone. Results: Five reported cases of risperidone-induced NMS were found in the literature. All cases including the one reported here displayed typical clinical features of NMS and all 6 patients had a prior history of extrapyramidal side effects and/or NMS. Age and duration of exposure to risperidone did not seem to be of significance. Conclusions: These cases illustrate that clinicians should be on the lookout for risperidone-induced NMS.

А case of heparin-induced thrombocytopenia in a patient with a novel coronaviral infection, features of diagnosis and treatment in a naval hospital conditions

2021 ◽  
Vol 7 (3) ◽  
pp. 71-77
Author(s):  
I. D. Shapovalov ◽  
V. E. Makarchenko ◽  
O. Yu. Kartina ◽  
T. L. Belousova
Keyword(s):  
Clinical Practice ◽  
Platelet Activation ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
Review Of The Literature ◽  
Heparin Induced Thrombocytopenia ◽  
Frequency Of Use ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Naval Hospital

The heparin-induced thrombocytopenia is a severe, potentially life-threatening complication of heparinotherpapia associated with thrombosis, develops as a result of antibody-mediated platelet activation. In the context of the SARS CoV-2 pandemic, the frequency of use of heparin in clinical practice has significantly increased, as a result of which the doctors have become more likely to face this complication. The article presents a review of the literature, describes the pathogenesis, modern algorithms for diagnosis and treatment, demonstrates a clinical case of heparin-induced thrombocytopenia in a patient with the SARS CoV-2, and discusses the features of diagnosis and treatment of this complication in a naval hospital.

scholarly journals Toxic effects of immunosuppressive drugs: mechanisms and strategies for controlling them

1996 ◽  
Vol 42 (8) ◽  
pp. 1316-1321 ◽  
Author(s):  
L M Shaw ◽  
B Kaplan ◽  
D Kaufman
Keyword(s):  
Mycophenolate Mofetil ◽  
Clinical Practice ◽  
Side Effects ◽  
Immunosuppressive Drugs ◽  
New Drugs ◽  
Therapeutic Drug ◽  
Clinical Effects ◽  
Transplant Patients ◽  
Life Threatening ◽  
Definition Of

Abstract Since cyclosporine (CsA) was introduced into clinical practice in late 1983 to prevent rejection in transplant patients, there has been an almost explosive growth in the number and types of transplants and the number of transplant centers, an increase in the life expectancy of the transplanted organ, and substantial decreases in rates of acute rejection and life-threatening infections. Despite these successes, major improvements in immunosuppressive therapy are needed, especially a reduction in toxic side effects and a rigorous definition of the relation between drug concentration and clinical effects. Such improvements may be achievable with the incorporation of new drugs such as tacrolimus and mycophenolate mofetil into immunosuppression protocols and the development of rigorously defined therapeutic drug-monitoring programs.

Life-threatening complications of Henoch-Schönlein purpura: diffuse alveolar haemorrhage, venous thrombosis and bowel ischaemia

2020 ◽  
Vol 13 (9) ◽  
pp. e235905
Author(s):  
Kezreen Kaur Dhaliwal ◽  
Nur Atikah Lile ◽  
Chou Luan Tan ◽  
Chong Hong Lim
Keyword(s):  
Venous Thrombosis ◽  
Systemic Vasculitis ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Henoch Schonlein Purpura ◽  
Bowel Ischaemia ◽  
Life Threatening ◽  
Schonlein Purpura ◽  
Purpuric Rash ◽  
Henoch Schönlein Purpura

Henoch-Schönlein purpura (HSP) is a common systemic vasculitis occurring in children. Making a diagnosis of HSP is often straightforward, managing its complications can be difficult. Diffuse alveolar haemorrhage (DAH), bowel ischaemia and venous thrombosis are rare complications of this disorder. We present a case of a 15-year-old teenage girl presenting with typical purpuric rash of HSP, developed DAH, bowel ischaemia and venous thrombosis. She was successfully treated with pulse methylprednisolone, intravenous Ig and intravenous cyclophosphamide.

scholarly journals Pulmonary manifestations of systemic vasculitis in childhood

Breathe ◽  
2020 ◽  
Vol 16 (4) ◽  
pp. 200211
Author(s):  
Adam Lawton ◽  
Joseph Machta ◽  
Thomas Semple ◽  
Atul Gupta
Keyword(s):  
Respiratory Disease ◽  
Systemic Vasculitis ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Pulmonary Infarction ◽  
Pulmonary System ◽  
Heterogenous Group ◽  
Pulmonary Manifestations ◽  
Respiratory Conditions ◽  
Prompt Diagnosis

The systemic vasculitides are a heterogenous group of rare conditions with an incompletely understood aetiology. Any of the systemic vasculitides may cause respiratory disease, but some conditions are more likely to affect the pulmonary system, often through pulmonary infarction and diffuse alveolar haemorrhage. These conditions are often difficult to diagnose due to their rarity and significant clinical overlap with common respiratory conditions. Prompt diagnosis and management can significantly reduce morbidity and mortality.

ANCA-associated life-threatening systemic vasculitis after alemtuzumab treatment for multiple sclerosis

2020 ◽  
Vol 26 (12) ◽  
pp. 1599-1602 ◽  
Author(s):  
Alice Horisberger ◽  
Vasiliki Pantazou ◽  
Géraldine Cuendet ◽  
Camillo Ribi ◽  
Vincent Dunet ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systemic Vasculitis ◽  
Cutaneous Vasculitis ◽  
Alveolar Haemorrhage ◽  
Diffuse Alveolar Haemorrhage ◽  
Immune Mediated ◽  
Auricular Chondritis ◽  
Relapsing Remitting ◽  
Life Threatening ◽  
Relapsing Remitting Multiple Sclerosis

Alemtuzumab is highly effective in relapsing remitting multiple sclerosis (RRMS), but autoimmune adverse events are of concern. In contrast to rare cases of immune-mediated cutaneous vasculitis, systemic vasculitis after alemtuzumab has not yet been described. We report the case of a 29-year-old man with RRMS who developed fever, auricular chondritis, cutaneous vasculitis and life-threatening diffuse alveolar haemorrhage, 12 months after alemtuzumab. Antibodies to myeloperoxidase appeared 9 months after alemtuzumab and were extremely high at the time of vasculitis. Outcome was favourable after glucocorticoids, plasma exchanges and rituximab. Thus, alemtuzumab may induce life-threatening vasculitis in patients treated for RRMS.

scholarly journals Anti-neutrophil cytoplasmic antibody–associated vasculitis complicated with diffuse alveolar haemorrhage and central nervous system vasculitis

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110118
Author(s):  
Takashi Nawata ◽  
Kaori Murakawa ◽  
Kosaku Shiragami ◽  
Masaki Shibuya ◽  
Makoto Kubo ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Systemic Vasculitis ◽  
Alveolar Haemorrhage ◽  
Simultaneous Occurrence ◽  
Cerebral Stroke ◽  
Diffuse Alveolar Haemorrhage ◽  
Central Nervous System Vasculitis ◽  
Rare Presentation ◽  
Life Threatening

Diffuse alveolar haemorrhage and central nervous system vasculitis are life-threatening complications of anti-neutrophil cytoplasmic antibody-associated vasculitis. The simultaneous occurrence of diffuse alveolar haemorrhage and central nervous system vasculitis is a rare presentation of antibody-associated vasculitis. Its diagnosis by histopathology is difficult because biopsy is difficult to perform, and urgent treatment is needed. We report a case of a Japanese man with diffuse alveolar haemorrhage and central nervous system vasculitis associated with antibody-associated vasculitis. New classification criteria may be needed for diffuse alveolar haemorrhage and central nervous system vasculitis associated with systemic vasculitis. When antibiotic-resistant atypical bilateral pneumonia is noted in the acute phase of a cerebral stroke, with elements suggestive of vasculitis, clinicians should be aware that diffuse alveolar haemorrhage and central nervous system vasculitis may occur simultaneously.

Azacitidine-induced pneumonitis and literature review

2020 ◽  
Vol 13 (10) ◽  
pp. e236349
Author(s):  
Paul Nguyen ◽  
Jawarya Safdar ◽  
Abdelaziz Mohamed ◽  
Ayman Soubani
Keyword(s):  
Side Effects ◽  
High Dose ◽  
Shortness Of Breath ◽  
Drug Reactions ◽  
X Ray ◽  
Injection Site Reactions ◽  
Life Threatening ◽  
Chest X Ray ◽  
Chemotherapy Agents ◽  
Acute Myeloid

We present a case of azacitidine-induced pneumonitis which is a rare adverse drug reaction and reported in less than 0.1% of cases. Common side effects of azacitidine are weakness, nausea, vomiting, constipation, injection site reactions, insomnia, among others. Our patient received azacitidine to treat her acute myeloid leukaemia and began to develop shortness of breath which progressed to dyspnoea at rest after completing a 7-day course of azacitidine and venetoclax. Initial chest X-ray revealed severe airspace disease for which the patient began receiving broad spectrum antibiotics, antifungals and antivirals therapy. Although infectious workup revealed invasive aspergillosis she did not clinically and radiologically improve despite being on isavuconazole until high-dose glucocorticoids were initiated. This case illustrates the importance of recognising and understanding the potential side effects of azacitidine and other chemotherapy agents as some adverse drug reactions can be life-threatening.

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