Cefazolin-induced hemolytic anemia: a case report and systematic review of literature

Abstract Background Cefazolin is a first-generation cephalosporin commonly used for skin and soft tissue infections, abdominal and orthopedic surgery prophylaxis, and methicillin-sensitive staph aureus. Cephalosporins as a whole are known potential inducers of hemolytic anemia; however, mechanism of action is primarily autoimmune, and compared to other drugs, cefazolin is the least common. Methods A rare case report of cefazolin-induced hemolytic anemia “CIHA” and a systematic review of CIHA articles in English literature. Two authors performed review of publications and articles were selected based on inclusion and exclusion criteria. A systematic search of the literature yielded 768 entries with five case reports on cefazolin-induced hemolytic anemia. Case presentation/results An 80-year-old female with methicillin-sensitive Staphylococcus aureus “MSSA” endocarditis. The patient was started on intravenous “IV” cefazolin that that resulted in hemolytic anemia and eosinophilia. Switching to vancomycin improved hemoglobin level and resolved eosinophilia. Four cefazolin-induced hemolytic anemia case reports and one population-based article with a case reported were analyzed with respect to direct antiglobulin test “DAT” (also known as the direct Coombs test) results, prior penicillin sensitivity, and acute anemia causes exclusion. Conclusions CIHA is a rare cause of clinically significant anemia. The diagnosis of drug-induced anemia is one of exclusion. It is important to consider DAT results and prior penicillin sensitivity when evaluating a patient for cefazolin-induced hemolytic anemia. However, the frequency of cefazolin use and resultant anemia necessitates early recognition of hemolytic anemia and prompt discontinuation of cefazolin, especially with long-term use.

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Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

Current Drug Safety ◽

10.2174/1574886315666200516175053 ◽

2020 ◽

Vol 15 (3) ◽

pp. 222-226 ◽

Cited By ~ 1

Author(s):

Asha K. Rajan ◽

Ananth Kashyap ◽

Manik Chhabra ◽

Muhammed Rashid

Keyword(s):

Case Report ◽

Infective Endocarditis ◽

Rare Case ◽

Case Reports ◽

Multidrug Resistant ◽

The Body ◽

Prior History ◽

Skin Reactions ◽

Rare Case Report ◽

Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

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Reticular erythematous mucinosis: Literature review and case report of a 24-year-old patient with systemic erythematosus lupus

Lupus ◽

10.1177/0961203320965702 ◽

2020 ◽

pp. 096120332096570

Author(s):

Juliana P Ocanha-Xavier ◽

Camila O Cola-Senra ◽

Jose Candido C Xavier-Junior

Keyword(s):

Systematic Review ◽

Case Report ◽

Literature Review ◽

English Language ◽

Case Reports ◽

Histopathological Diagnosis ◽

Skin Disorders ◽

Histopathological Findings ◽

Inflammatory Skin

Reticular erythematous mucinosis (REM) was first described 50 years ago, but only around 100 case reports in English have been published. Its relation with other inflammatory skin disorders is still being debated. We report a case of REM, including the clinical and histopathological findings. Also, a systematic review of 94 English-language reported cases is provided. The described criteria for clinical and histopathological diagnosis are highlighted in order to REM can be confidently diagnosed.

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The toxic effects of chloroquine and hydroxychloroquine on skeletal muscle: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-86079-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Claudia Cristina Biguetti ◽

Joel Ferreira Santiago Junior ◽

Matthew William Fiedler ◽

Mauro Toledo Marrelli ◽

Marco Brotto

Keyword(s):

Systematic Review ◽

Quantitative Analysis ◽

Qualitative Analysis ◽

Observational Studies ◽

Skeletal Muscles ◽

Case Reports ◽

Meta Analysis ◽

Toxic Effects ◽

Drug Induced ◽

Qualitative And Quantitative

AbstractThe aim of this systematic review was to perform qualitative and quantitative analysis on the toxic effects of chloroquine (CQ) and hydroxychloroquine (HCQ) on skeletal muscles. We designed the study according to PRISMA guidelines. Studies for qualitative and quantitative analyses were selected according to the following inclusion criteria: English language; size of sample (> 5 patients), adult (> age of 18) patients, treated with CQ/HCQ for inflammatory diseases, and presenting and not presenting with toxic effects on skeletal muscles. We collected data published from 1990 to April 2020 using PubMed, Cochrane Library, EMBASE, and SciELO. Risk of bias for observational studies was assessed regarding the ROBIN-I scale. Studies with less than five patients (case reports) were selected for an additional qualitative analysis. We used the software Comprehensive Meta-Analysis at the confidence level of 0.05. We identified 23 studies for qualitative analysis (17 case-reports), and five studies were eligible for quantitative analysis. From case reports, 21 patients presented muscle weakness and confirmatory biopsy for CQ/HCQ induced myopathy. From observational studies, 37 patients out of 1,367 patients from five studies presented muscle weakness related to the use of CQ/HCQ, and 252 patients presented elevated levels of muscle enzymes (aldolase, creatine phosphokinase, and lactate dehydrogenase). Four studies presented data on 34 patients with confirmatory biopsy for drug-induced myopathy. No study presented randomized samples. The chronic use of CQ/HCQ may be a risk for drug-induced myopathy. There is substantiated need for proper randomized trials and controlled prospective studies needed to assess the clinical and subclinical stages of CQ/HCQ -induced muscle myopathy.

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A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synchronous and metachronous gastrointestinal NET

Clinical Journal of Gastroenterology ◽

10.1007/s12328-020-01255-9 ◽

2020 ◽

Author(s):

Francesco Lancellotti ◽

Luigi Solinas ◽

Davide Telesco ◽

Andrea Sagnotta ◽

Augusto Belardi ◽

...

Keyword(s):

Neuroendocrine Tumor ◽

Colorectal Adenocarcinoma ◽

Retrospective Studies ◽

Case Reports ◽

English Literature ◽

Case Series ◽

Population Based ◽

Review Articles ◽

Gastrointestinal Neuroendocrine Tumor

Abstract Gastrointestinal neuroendocrine tumor (NET) associated with a metachronous intestinal adenocarcinoma is rare. We report the case of a 71-year-old man with an ileal NET. Patient has previously undergone a left colectomy for sigmoid cancer. We report a complete review both of the metachronous and synchronous NET. A comprehensive systematic literature search in PubMed, EMBASE, and MEDLINE identified a total of 35 relevant studies. This study includes an analysis of review articles, case reports, case series, retrospective studies and population-based studies. In the English literature to date, there are 21 case reports (19 synchronous cases and 2 metachronous cases), 3 case series and 3 review articles, and less than 10 retrospective studies or population-based studies. A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma and 3 patients with metachronous gastrointestinal NET and colorectal adenocarcinoma. The incidence of synchronous cancer (particularly for colorectal and gastric cancer) with a gastrointestinal NET ranges from 10 to 50%, while for the metachronous ones it is still unclear. This is the third metachronous case report and the first descriptive case of gastrointestinal NET diagnosed 2 years after a colorectal adenocarcinoma. An endoscopic follow-up program for gastrointestinal NET patients and/or for first-degree relatives of NET patients appears recommendable.

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Systematic review of Kabuki Syndrome’s phenotype with KMT2D gene mutation

Revista Intertox de Toxicologia Risco Ambiental e Sociedade ◽

10.22280/revintervol12ed1.426 ◽

2019 ◽

Vol 12 (1) ◽

Author(s):

Leonardo Bonini Fischetti ◽

Julia Zaccarelli Magalhães ◽

André Rinaldi Fukushima ◽

Paula Waziry ◽

Esther Lopes Ricci

Keyword(s):

Systematic Review ◽

Differential Diagnosis ◽

Case Report ◽

Animal Models ◽

Case Reports ◽

Accurate Diagnosis ◽

Kabuki Syndrome ◽

Live Births ◽

Comparative Review ◽

Secondary Phenotypes

Kabuki Syndrome is rare and poorly documented, initially mentioned by Niikawa and Kuroki in 1981. The prevalence of the syndrome among live births is 1:32,000. Case reports are now available, which correlates to improved techniques for accurate diagnosis. This study focused on a systematic comparative review of the phenotypes of individuals with Kabuki Syndrome, with the purpose to facilitate diagnosis. The systematic review was done with a bibliographic survey of case studies using the following databases: Pubmed, Science Direct and Google Scholar, in conjunction with the following key-words: Kabuki syndrome, phenotype, KMT2D and case report. The literature shows that patients with this syndrome present five main characteristics, besides several types of secondary phenotypes. These characteristics present variations in permeability as well as expressivity of some genes in individuals, therefore, a characterization through phenotype alone becomes limited, making it necessary to perform genetic analysis for differential diagnosis. In order to increase the knowledge and elucidate mechanisms of Kabuki syndrome, we suggest further studies that utilize animal models.

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Clinical spectrum and severity of hemolytic anemia in glucose 6-phosphate dehydrogenase–deficient children receiving dapsone

Blood ◽

10.1182/blood-2012-03-416032 ◽

2012 ◽

Vol 120 (20) ◽

pp. 4123-4133 ◽

Cited By ~ 60

Author(s):

Allan Pamba ◽

Naomi D. Richardson ◽

Nick Carter ◽

Stephan Duparc ◽

Zul Premji ◽

...

Keyword(s):

Blood Transfusion ◽

Hemolytic Anemia ◽

G6pd Deficiency ◽

Case Reports ◽

Drug Induced ◽

Once Daily ◽

Maximum Decrease ◽

Life Threatening ◽

The Mean ◽

Glucose 6 Phosphate Dehydrogenase

AbstractDrug-induced acute hemolytic anemia led to the discovery of G6PD deficiency. However, most clinical data are from isolated case reports. In 2 clinical trials of antimalarial preparations containing dapsone (4,4′-diaminodiphenylsulfone; 2.5 mg/kg once daily for 3 days), 95 G6PD-deficient hemizygous boys, 24 G6PD-deficient homozygous girls, and 200 girls heterozygous for G6PD deficiency received this agent. In the first 2 groups, there was a maximum decrease in hemoglobin averaging −2.64 g/dL (range −6.70 to +0.30 g/dL), which was significantly greater than for the comparator group receiving artemether-lumefantrine (adjusted difference −1.46 g/dL; 95% confidence interval −1.76, −1.15). Hemoglobin concentrations were decreased by ≥ 40% versus pretreatment in 24/119 (20.2%) of the G6PD-deficient children; 13/119 (10.9%) required blood transfusion. In the heterozygous girls, the mean maximum decrease in hemoglobin was −1.83 g/dL (range +0.90 to −5.20 g/dL); 1 in 200 (0.5%) required blood transfusion. All children eventually recovered. All the G6PD-deficient children had the G6PD A− variant, ie, mutations V68M and N126D. Drug-induced acute hemolytic anemia in G6PD A− subjects can be life-threatening, depending on the nature and dosage of the drug trigger. Therefore, contrary to current perception, in clinical terms the A− type of G6PD deficiency cannot be regarded as mild. This study is registered at http://www.clinicaltrials.gov as NCT00344006 and NCT00371735.

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Elbow Dislocation with Ipsilateral Radial Shaft Fracture – A Case Report

Revista Iberoamericana de Cirugía de la Mano ◽

10.1055/s-0039-1688568 ◽

2019 ◽

Vol 47 (02) ◽

pp. 131-136

Author(s):

Marcio Aurelio Aita ◽

Ricardo Kaempf de Oliveira ◽

Rafael Pêgas Praetzel ◽

Fernando Towata ◽

Pedro Jose Delgado ◽

...

Keyword(s):

Case Report ◽

Early Recognition ◽

Case Reports ◽

Elbow Dislocation ◽

Shaft Fracture ◽

Clinical Results ◽

Urgent Care ◽

Dash Score ◽

Radial Fracture ◽

Palmar Approach

Background Posterior dislocation of the elbow associated to a radial shaft fracture is a rare lesion, its treatment is difficult and complicated, and the indications, surgical options, and timing of surgery may vary. In the present case, we performed immediately after the trauma (urgent care) an open reduction internal fixation (ORIF) surgery of the radial fracture by means of a 3.5 mm locking plate, associated to closed elbow reduction and stabilization with dynamic bracing. Case Report A 26-year-old woman was seen in our service with a traumatic deformity of her right, dominant forearm and elbow after a fall from a balance board and presented with a radial shaft fracture and posterior elbow dislocation. The palmar approach was used and the shaft fracture was fixated. During the radial fracture reduction maneuver, the dislocation of the elbow was spontaneously reduced. At 1 year postoperatively, the patient showed good wrist, forearm, and elbow range of motion (ROM). Disabilities of the arm, shoulder and hand (DASH) score of 5, visual analogue scale (VAS) of 0, and grip strength of 92%, as compared with the nonaffected side. Clinical Relevance Nowadays, case reports of concomitant, ipsilateral multiple injuries that uncommonly occur together in a single traumatic episode are very rare. The awareness of this association for early recognition is of paramount significance for ideal clinical results.

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Transurethral resection of a bladder trigone leiomyoma: a rare case report

BMC Urology ◽

10.1186/s12894-020-00722-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Athanasios Zachariou ◽

Maria Filiponi ◽

Fotios Dimitriadis ◽

Aris Kaltsas ◽

Nikolaos Sofikitis

Keyword(s):

Case Report ◽

Transurethral Resection ◽

English Literature ◽

Benign Tumors ◽

Macroscopic Hematuria ◽

Urinary Tract Symptoms ◽

Rare Case Report ◽

Long Term Follow Up

Abstract Background Bladder leiomyomas are rare and benign tumors of the bladder. They account for 0.43% of all bladder tumors, and only 250 cases have been reported in English literature. Based on the size and localization of the lesion, their symptoms vary considerably. Women seem to be more affected, and obstructive symptoms predominate. Surgical treatment is almost always highly effective, leaving a low recurrence rate. Case presentation We present a clinical case of a 52-year old man with macroscopic hematuria and obstructive lower urinary tract symptoms due to a large bladder trigone leiomyoma. CT and MRI showed a well-defined large bladder leiomyoma and cystoscopy established the initial findings. The patient underwent successful transurethral resection of the lesion, and pathology findings confirmed the diagnosis. Conclusions This case report demonstrates that transurethral resection of a large bladder trigone leiomyoma is a feasible and successful procedure. Long term follow-up proves that there is neither scarring distortion of the bladder trigone area nor damage in the ureteral orifices, even though there was a thorough removal of the trigone wall.

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Desmoplastic Small Round Cell Tumor of the Ovary: A Case Report with a New Modality of Treatment and Review of the Literature

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1710350 ◽

2020 ◽

Vol 42 (05) ◽

pp. 297-302

Author(s):

Goran Vujić ◽

Mislav Mikuš ◽

Luka Matak ◽

Aleksandra Bonevski ◽

Ivan Babić ◽

...

Keyword(s):

Case Report ◽

English Literature ◽

Large Population ◽

Population Based ◽

Cell Tumor ◽

Round Cell ◽

Round Cell Tumor ◽

Small Round Cell Tumor ◽

Small Round Cell ◽

Chemotherapy Protocol

Abstract Objective Desmoplastic small round cell tumor (DSRCT) is a rare intraabdominal neoplasm that grows along serosal surfaces and is primarily found in young men. To date, only 16 cases of ovarian DSRCT have been previously reported in women in the English literature, and no large population-based studies on this topic exist. Case Report We report the case of a 19-year-old virgo with unremarkable past medical history, initially presented with abdominal fullness. After being treated with the optimal treatment modality (primary and secondary surgical debulking, unique chemotherapy, protocol and adjuvant radiotherapy), the patient has remained without tumor disease for 40 months. Conclusion Although the best therapy for patients with DSRCT has yet to be determined, combining complete surgical resection, adjuvant chemotherapy, and radiotherapy is required to prolong survival and to achieve proper quality of life.

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Chlorambucil-Induced Acute Interstitial Pneumonitis

Case Reports in Hematology ◽

10.1155/2014/575417 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5

Author(s):

Hammad Shafqat ◽

Adam J. Olszewski

Keyword(s):

Systematic Review ◽

Interstitial Pneumonitis ◽

Pulmonary Toxicity ◽

Alkylating Agent ◽

Randomized Trials ◽

Case Reports ◽

Lymphocytic Leukemia ◽

Mechanism Of Injury ◽

Review Of Literature ◽

Drug Induced

Chlorambucil is an alkylating agent commonly used in treatment of chronic lymphocytic leukemia (CLL). We report a case of interstitial pneumonitis developing in an 83-year-old man 1.5 months after completing a six-month course of chlorambucil for CLL. The interstitial pneumonitis responded to therapy with prednisone. We performed a systematic review of literature and identified 13 other case reports of chlorambucil-induced pulmonary toxicity, particularly interstitial pneumonitis. No unifying risk factor could be discerned and the mechanism of injury remains unknown. In contrast, major randomized trials of chlorambucil therapy in CLL have not reported interstitial pneumonitis as an adverse effect, which may be due to the rarity of the phenomenon or due to underreporting of events occurring after completion of treatment. Clinicians should consider drug-induced interstitial pneumonitis in the differential diagnosis of a suggestive syndrome developing even after discontinuation of chlorambucil.

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