Cutaneous adverse reaction during lithium treatment: a case report and updated systematic review with meta-analysis

Objective. To compare the efficacy and safety of kidney-tonifying and blood-activating medicinal herbs (KTBAMs) and nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of knee osteoarthritis (KOA). Methods. Randomized controlled trials (RCTs) from online databases that compared the efficacy of KTBAMs and NSAIDs in the treatment of KOA were retrieved. The main outcomes included the evaluation of functional outcomes, pain, and adverse effects. The Cochrane risk-of-bias (ROB) tool was used to assess methodological quality. Results. A total of 38 RCTs (3994 participants) were included in our meta-analysis. We found that KTBAMs had a significantly higher total effective rate (P<0.00001, risk ratio (RR) = 1.08, confidence interval (CI) = 1.05 to 1.11, I2 = 4%) and a lower gastrointestinal adverse reaction rate (P<0.00001, RR = 0.36, CI = 0.24 to 0.53, I2 = 33%) than NSAIDs. KTBAMs showed greater improvements in the Knee Society Scale (KSS) scores (mean difference (MD) = 7.17, 95% CI 0.71 to 13.64, P=0.03). Regarding the visual analog scale (VAS) scores, WOMAC scores, and Lequence scores, there were no significant differences between the KTBAM group and the NSAID group. The GRADE quality level of this systematic review indicated that the very low-quality evidence showed that KTBAMs had a higher total effective rate, while the moderate-quality evidence showed that the adverse reactions of KTBAMs were lower and the KSS scores were higher. Low-quality evidence showed no significant differences in improving VAS scores, WOMAC scores, or Lequence scores. Conclusion. KTBAMs were superior to NSAIDs in terms of a higher total effective rate, a lower adverse reaction rate, and a higher KSS score. There were no significant differences between KTBAMs and NSAIDs in improving VAS scores, WOMAC scores, and Lequence scores of patients with KOA. Therefore, KTBAMs may be an alternative effective method for treating KOA. However, high-quality, well-designed RCTs with long-term follow-up are still required.

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Hydrochlorothizide-induced acute generalised exanthematous pustulosis presenting with bilateral periorbital impetigo

BMJ Case Reports ◽

10.1136/bcr-2017-223528 ◽

2019 ◽

Vol 12 (2) ◽

pp. bcr-2017-223528 ◽

Cited By ~ 3

Author(s):

Leo E Reap ◽

Cassandra Rodd ◽

Jose Larios ◽

Michael Marshall

Keyword(s):

Adverse Reaction ◽

Case Report ◽

Cutaneous Adverse Reaction ◽

Common Causes ◽

Erythematous Plaques ◽

Exanthematous Pustulosis

Acute generalised exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction characterised by the appearance of erythematous plaques and papules with overlying non-follicular pinpoint pustules. Drugs are the cause of AGEP in approximately 90% of cases. The most common causes include anti-infective agents (aminopenicillins, quinolones, antibacterial sulfonamides and terbinafine), antimalarials and diltiazem. To the best of our knowledge, to date there has only been one report of hydrochlorothiazide-induced AGEP. There has never been a case report of losartan-induced AGEP. Here, we present a case of AGEP that is the second case purportedly caused by hydrochlorothiazide.

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The Deleterious Effects of COVID-19 in the Peripartum Period: A Case Report

Pediatric Reports ◽

10.3390/pediatric13020041 ◽

2021 ◽

Vol 13 (2) ◽

pp. 334-339

Author(s):

Alixandria F. Pfeiffer ◽

Rosylyn James ◽

Barbara K. Neuhoff ◽

Wilson B. Pfeiffer ◽

David R. Lowery ◽

...

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Case Report ◽

Global Health ◽

Respiratory Distress ◽

Meta Analysis ◽

Significant Risk ◽

Recent Systematic Review ◽

Peripartum Period ◽

Recent Attention

While the Coronavirus Disease 2019 (COVID-19) pandemic continues to wreak havoc across the nation and the globe as one of the most significant global health crises of our time, recent attention has been turned to the effects of COVID-19 on pregnancy and the puerperium. Although most cases have been asymptomatic, for some patients, the disease may be accompanied by serious complications such as pneumonia, acute respiratory distress, multi organ failure, and death. Several case studies have noted that patients with co-morbidities are at a significant risk of these complications. In a recent systematic review and meta-analysis, authors conclude that cardiovascular disease was associated with increased composite poor outcome in patients with COVID-19. The following case report highlights the multi-system complications and severity of symptoms that can take place after childbirth in a patient with co-morbid obstetric and prenatal conditions and an initially asymptomatic COVID-19 infection.

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Adverse reaction to metal debris due to fretting corrosion between the acetabular components of modular dual-mobility constructs in total hip replacement: a systematic review and meta-analysis

EFORT Open Reviews ◽

10.1302/2058-5241.6.200146 ◽

2021 ◽

Vol 6 (5) ◽

pp. 343-353

Author(s):

Jonathan M. R. French ◽

Paul Bramley ◽

Sean Scattergood ◽

Nemandra A. Sandiford

Keyword(s):

Systematic Review ◽

Adverse Reaction ◽

Total Hip Replacement ◽

Hip Replacement ◽

Meta Analysis ◽

Fretting Corrosion ◽

Metal Debris ◽

Dual Mobility ◽

Total Hip ◽

Metal Liner

Modular dual-mobility (MDM) constructs can be used to reduce dislocation rates after total hip replacement (THR). However, there are concerns about adverse reaction to metal debris (ARMD) as a result of fretting corrosion between the metal liner and shell. This systematic review reports outcomes following THR using MDM components. It was registered with PROSPERO and conducted in line with Cochrane and PRISMA recommendations. Sixteen articles were included overall, with meta-analysis performed on relevant subsets using a random intercept logistic regression model. Estimated median incidence of ARMD requiring revision surgery within study follow-up period was 0.3% (95% CI 0.1 – 1.8%, from 11 cohort studies containing 1312 cases). Serum metal ion levels were mildly raised in 7.9% of cases, and significantly raised in 1.8%, but there was no correlation with worse clinical hip function scores within studies. Dislocation rate was 0.8%. Revision rate was 3.3%. There are mixed reports of wear on the backside of the metal liner from the acetabular shell and screw heads. Both implant design and component malseating are implicated, but currently it is unclear to what extent each factor is responsible. Studies were poor quality with high risk of confounding, especially from trunnion corrosion. We have made recommendations for further work. In the meantime, surgeons should be aware of the potential risk of ARMD when considering using an MDM prosthesis, and, if selecting one, must ensure proper seating of the liner and screws intraoperatively. Cite this article: EFORT Open Rev 2021;6:343-353. DOI: 10.1302/2058-5241.6.200146

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Stevens-Johnson syndrome induced by phenytoin: a case report

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20164781 ◽

2016 ◽

Vol 6 (1) ◽

pp. 208

Author(s):

Lalkota Prakash Bhanu ◽

Kumara Swamy M. ◽

Mohammed Nasiruddin ◽

Naveen H. D. ◽

Rajesh Venkataraman

Keyword(s):

Adverse Reaction ◽

Case Report ◽

Toxic Epidermal Necrolysis ◽

Antiepileptic Drugs ◽

Stevens Johnson Syndrome ◽

Drug Reactions ◽

Cutaneous Adverse Reaction ◽

Johnson Syndrome ◽

Life Threatening ◽

Grade 3

Stevens-Johnson syndrome (SJS) and Toxic epidermal necrolysis (TEN) are rare (one to two per 10,00,00 population per year) but life threatening adverse drug reactions. Antiepileptic drugs-induced Stevens-Johnson syndrome (SJS) is a life-threatening severe cutaneous adverse reaction, amongst anti-epileptics; carbamazepine and phenytoin are the major culprits. We report here a case of SJS due to phenytoin (CTC vs 2 Grade 3).

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Doxycycline-Associated Dual Cutaneous Adverse Reaction to the Drug (CARD): Case Report of Concurrent Photosensitivity and Morbilliform Exanthem to Doxycycline

Cureus ◽

10.7759/cureus.11546 ◽

2020 ◽

Author(s):

Joanne S Jacob ◽

Philip R Cohen

Keyword(s):

Adverse Reaction ◽

Case Report ◽

Cutaneous Adverse Reaction

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IDH1-mutant primary intraventricular gliosarcoma: Case report and systematic review of a rare location and molecular profile

Surgical Neurology International ◽

10.25259/sni_586_2020 ◽

2020 ◽

Vol 11 ◽

pp. 372

Author(s):

Leonardo Jose Monteiro de Macedo Filho ◽

Esther Grangeiro Barreto ◽

Paulo Levi Bezerra Martins ◽

Euler Nicolau Sauaia Filho ◽

Gunter Gerson ◽

...

Keyword(s):

Systematic Review ◽

Case Report ◽

Meta Analysis ◽

Memory Loss ◽

Idh1 Mutation ◽

Molecular Profile ◽

Forest Plot ◽

Histopathological Study ◽

Rare Location ◽

Microsurgical Resection

Background: Gliosarcoma (GS) is classified as an IDH-wild-type variant of glioblastoma (GBM). While GS is already an unusual presentation of GBM, IDH1-mutant cases are especially rare. We present an IDH1-mutant primary intraventricular GS case report and a systematic review of the molecular profile in GS correlating to the prognostic and pathogenesis of IDH1/2 mutations. Case Description: A 44-years-old man presented with ongoing fatigue symptoms and a new-onset intense occipital headache. The patient complained of memory loss, dyscalculia, and concentration difficulties. An MRI revealed a bihemispheric intraventricular mass crossing the midline through the corpus callosum and infiltrating the trigone of the lateral ventricles, hypointense, and hyperintense on the T1- and T2-weighted image. We performed a microsurgical resection with a transparietal transsulcal approach; however, the contralateral mass was attached to vascular structures and we decided to reoperate the patient in another moment. The histopathological study showed a Grade IV tumor and the immunohistochemistry confirmed the diagnosis of GS. The patient presented progressive neurologic decline and died 45 days after the surgical approach. Conclusion: We did two systematic reviews studies from PubMed, EMBASE, MEDLINE, Cochrane, and SCOPUS databases, and included molecular and intraventricular studies of GS. We performed further meta-analysis using OpenMetaAnalyst™ software. We conducted a forest plot with the molecular profile of GS. When correlated IDH1 mutation versus tp53 mutation, we found an odds ratio (OR) of 0.018 (0.005–0.064) and P < 0.001. Moreover, we compared IDH1 mutation versus MGMT methylation (P = 0.006; OR = 0.138 [0.034–0.562]). The studies evaluating the molecular profile in GS prognostics are often extended from all GBMs despite specifics GBM variants (i.e., GS). We found a correlation between IDH1 mutation expression with tp53 and MGMT expression in GS, and future studies exploring this molecular profile in GS are strongly encouraged.

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