DRESS/DIHS syndrome induced by sulfasalazine

2021 ◽  
Vol 31 (6) ◽  
pp. 822-826
Author(s):  
Irina V. Demko ◽  
Elena A. Sobko ◽  
Olga P. Ischenko ◽  
Angelina Yu. Kraposhina ◽  
Larisa V. Aristarchova ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Lymph Nodes ◽  
Clinical Case ◽  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Dress Syndrome ◽  
Proper Management ◽  
Adequate Therapy ◽  
Causative Agents ◽  
Inflammatory Drugs

Among the manifestations of drug hypersensitivity, DRESS/DIHS syndrome is of particular importance. The clinical manifestations include rash, enlarged lymph nodes, fever, hepatitis, leukocytosis with eosinophilia, as well as the involvement of other organs and systems. The most common causative agents include anticonvulsants, antidepressants, sulfanilamides, non-steroidal anti-inflammatory drugs, and allopurinol, but the list is constantly expanding. The exact pathogenesis of DRESS/DIHS syndrome is currently unclear. Timely diagnosis and adequate therapy can improve prognosis of this disease. In our clinical case, DRESS syndrome developed after the patient was administered sulfasalazine for erosive proctosigmoiditis. In order to ensure adequate prevention, early diagnosis, and proper management of DRESS syndrome, it is necessary to raise awareness of practitioners of different specialties about the possibility of developing this undesirable reaction to pharmacotherapy.

CLINICAL CASE: MICROSCOPIC POLYANGIITIS AS ONE OF THE MAIN VARIANTS OF PULMONARY-RENAL SYNDROME

Vestnik ◽  
2021 ◽  
pp. 345-349
Author(s):  
М.А. Жанузаков ◽  
М.К. Бапаева ◽  
А.Ж. Шурина ◽  
Э.М. Утежанов
Keyword(s):  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Research Methods ◽  
Clinical Case ◽  
Microscopic Polyangiitis ◽  
Clinical Manifestations ◽  
Additional Research ◽  
Treatment Goal ◽  
Adequate Treatment ◽  
Pulmonary Renal Syndrome

Клинические проявления микроскопического полиангиита многообразны, что затрудняет своевременную диагностику и соответственно адекватное лечение. Цель: привлечь внимание терапевтов, пульмонологов, нефрологов к своевременному выявлению легочно-почечного синдрома и установлению его нозологической основы, в частности микроскопического полиангиита на примере клинического случая. Материалы и методы: проведены обследование пациента с микроскопическим полиангиитом и дифференциальная диагностика в рамках легочно-почечного синдрома. Результаты: на основании анамнеза заболевания, результатов клинического и дополнительных методов исследования пациента, установлен диагноз микроскопического полиангиита. Выводы: для ранней диагностики микроскопического полиангиита необходима настороженность при возникновении легочно-почечного синдрома в виде сочетания гломерулонефрита и геморрагического альвеолита на фоне сосудистой пурпуры. Clinical manifestations of microscopic polyangiitis are diverse, which complicates timely diagnosis and, accordingly, adequate treatment. Goal: to draw the attention of therapists, pulmonologists, nephrologists to the timely detection of pulmonary-renal syndrome and the establishment of its nosological basis, in particular microscopic polyangiitis by the example of a clinical case. Materials and methods: an examination of a patient with microscopic polyangiitis and differential diagnosis within the framework of pulmonary-renal syndrome were carried out. Results: based on the anamnesis of the disease, the results of clinical and additional research methods of the patient, the diagnosis of microscopic polyangiitis was established. Conclusions: for early diagnosis of microscopic polyangiitis, alertness is necessary in the event of pulmonary-renal syndrome in the form of a combination of glomerulonephritis and hemorrhagic alveolitis against the background of vascular purpura.

scholarly journals A clinical case of early successful diagnosis and treatment of relapsing polychondritis

2019 ◽  
Vol 56 (6) ◽  
pp. 782-784
Author(s):  
E. N. Sukhikh ◽  
O. V. Simonova
Keyword(s):  
Early Diagnosis ◽  
Clinical Case ◽  
Structural Changes ◽  
Clinical Manifestations ◽  
Relapsing Polychondritis ◽  
Complete Disappearance ◽  
Cartilaginous Tissue ◽  
Autoimmune Inflammatory Disease ◽  
The World ◽  
Risk Of Relapse

Relapsing polychondritis (RP) is a generalized progressive autoimmune inflammatory disease of the cartilaginous tissue, which leads to structural changes in the cartilage until its complete disappearance. To date, about 800 RP cases have been described in the world. The clinical manifestations of RP are diverse, which often complicates the early diagnosis of the disease. The most commonly used drugs to stop RP activity are glucocorticoids, the dose of which depends on the severity of its clinical manifestations, but there is no evidence for their effect on the progression of the process and the risk of relapse. The paper describes a clinical case of early diagnosis and successful treatment of the disease, which could prevent possible complications and disability in the patient.

scholarly journals Nonsteroidal anti-inflammatory drugs-induced hypersensitivity reactions

2019 ◽  
pp. 411-416
Author(s):  
Andrei Gheorghe Vicovan ◽  
Liliana Veres ◽  
Andrei Cucu ◽  
Dana Turliuc ◽  
Cristina Mihaela Ghiciuc
Keyword(s):  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Clinical Analysis ◽  
In Vitro Tests ◽  
Hypersensitivity Reactions ◽  
Immunological Mechanism ◽  
Immunological Mechanisms ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

The role of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in neurosurgical practice is a secondary one, however they are still constantly involved in perioperative management of pain or in nonoperative management of acute radiculopathy. Beside the well-known adverse reactions (ADRs), the neurosurgeon practitioner should also take in account the drug hypersensitivity reactions (DHRs) of NSAIDs and be able to deal with it. The aim of this paper was to review the diagnostic and management steps for NSAIDs-induced Hypersensitivity Reactions. The actual stratification of NSAIDs-induced Hypersensitivity Reactions is based on understanding of the heterogeneity of immunological/non-immunological mechanisms of reactions and complexity of clinical manifestations. Practically, this stratification allows the physician to assess suspicion of DHR, based on anamnesis and clinical analysis, and to consider further practical steps to manage and eventually confirm the diagnosis. Drug allergies are considered only the DHRs for which a definite immunological mechanism (either drug-specific antibody or T cell) is demonstrated. In conclusion, clinical analysis and anamnesis of patient with NSAIDs-induced Hypersensitivity Reactions can be realized by any physician and could be enough to diagnose, but it is not sufficient to confirm the diagnosis. In vitro tests and oral provocation challenges may be necessary to be undertaken by an allergy specialist.

DIAGNOSTIC CRITERIA EARLY DIAGNOSIS ENDOMETRIOSIS

2021 ◽  
Vol 2 (1) ◽  
pp. 62-64
Author(s):  
Bakhtiyarova D.R.
Keyword(s):  
Family History ◽  
Iron Deficiency ◽  
Early Diagnosis ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Uterine Bleeding ◽  
Deficiency Anemia ◽  
The Family ◽  
Patient’S History ◽  
Uterine Body

The purpose of this study is to study a clinical case of late diagnosis of endometriosis of the uterine body (adenomyosis), despite the presence of such typical clinical manifestations as heavy uterine bleeding, leading to the formation of chronic post – hemorrhagic iron deficiency anemia and the development of sideropenic syndrome, accompanied by weakness, dizziness, rapid fatigue, brittle hair and nails. Also, the data of the family history (endometriosis in the mother) and the patient's history indicating the presence of pollinosis and bronchial asthma were not taken into account.

scholarly journals CLINICAL CASE OF MENTAL DISORDERS IN THE DEBUTOF MULTIPLE SCLEROSIS

2017 ◽  
Vol 9 (3) ◽  
pp. 114-120
Author(s):  
S N Zhulev ◽  
A A Toropova ◽  
O N Nemykin ◽  
M V Fomintseva ◽  
Yu O Garyshina ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mental Disorders ◽  
Early Diagnosis ◽  
Clinical Case ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Neurologic Deficit ◽  
Appropriate Treatment ◽  
Observation Period

In a course of multiple sclerosis neurologic deficit could be overshadowed by psychotic signs such as catatonia, depression and dementia. Thus, ignoring these clinical manifestations can pre- vent early diagnosis of multiple sclerosis. Subsequently, an appropriate treatment will be delayed. In our article we report a case of multiple sclerisos in patient presented initially with catatonia, depression and dementia. Psychiatric, neurological, MRI picture and treatment impact thoroughly throughout the whole observation period are described. This case illustrates that catatonia can be dominating feature in the clinical course of multiple sclerosis and can overshadow other neurologic signs.

Ipersensibilità ai FANS: intolleranza o allergia?

2021 ◽  
Vol 40 (1) ◽  
pp. 37-43
Author(s):  
Laura Levantino ◽  
Cristiana Corrado ◽  
Laura Badina ◽  
Sara Lega ◽  
Egidio Barbi
Keyword(s):  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Hypersensitivity Reactions ◽  
Provocation Tests ◽  
Immunological Mechanisms ◽  
Drug Hypersensitivity Reactions ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Drug Provocation Tests ◽  
Cox 1

Non-steroidal anti-inflammatory drugs (NSAIDs) are the main triggers of drug hypersensitivity reactions in children. According to the EAACI latest classification NSAIDs hypersensitivity reactions are differentiated into cross-reactive reactions, with non-immunological mechanisms (based on COX-1 inhibition), and selective reactions, with immunological mechanisms. Paediatric clinical manifestations of NSAID hypersensitivity are typically cutaneous, but sometimes, similarly to anaphylaxis, can involve other systems, especially the respiratory one. Differentiating between NSAID intolerance and NSAID allergy through drug provocation tests is crucial for the patient because the two clinical entities require different management.

A case of early diagnosis of toxic cardiomyopathy in a patient receiving tamoxifen for breast cancer

2021 ◽  
Vol 7 (3) ◽  
pp. 7-10
Author(s):  
Yu. Gvela ◽  
Natal'ya Kinyasheva
Keyword(s):  
Breast Cancer ◽  
Early Diagnosis ◽  
Cancer Patients ◽  
Young Woman ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Diagnostic Techniques ◽  
Chemotherapy Drugs

The article is devoted to the problem of cardiotoxicity of chemotherapy drugs used in cancer patients, the nonspecificity of early clinical manifestations of cardiomyopathy developing against this background, and the search for informative diagnostic techniques to confirm this disease. As an illustration, a clinical case of cardiomyopathy in a young woman who developed against the background of chemotherapy for breast cancer is presented.

CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME: DIAGNOSTICS AND TREATMENT

Vestnik ◽  
2021 ◽  
pp. 341-344
Author(s):  
М.А. Жанузаков ◽  
М.К. Бапаева ◽  
Г.К. Джалилова ◽  
А.Ж. Шурина ◽  
Э.М. Утежанов
Keyword(s):  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Multiple Organ Failure ◽  
Antiphospholipid Syndrome ◽  
Disseminated Intravascular Coagulation ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Multiple Organ ◽  
Catastrophic Antiphospholipid Syndrome ◽  
Adequate Treatment

Клинические проявления катастрофического антифосфолипидного синдрома многообразны, что затрудняет своевременную диагностику и соответственно адекватное лечение. Цель: устранить трудности, возникающие у практических врачей при постановке диагноза, дифференциальной диагностике и лечении катастрофического антифосфолипидного синдрома, основываясь на анализе данных литературы и на примере клинического случая. Материалы и методы: исследований по данной проблеме в отечественных источниках мы не встретили, что привело к необходимости остановиться на литературных данных и клиническом примере. Результаты: на основании анамнеза заболевания, результатов клинического и дополнительных методов исследования пациента, установлен диагноз катастрофического антифосфолипидного синдрома. Выводы: для ранней диагностики катастрофического антифосфолипидного синдрома необходима настороженность при возникновении признаков ДВС-синдрома и быстро развивающейся полиорганной недостаточности. Clinical manifestations of the catastrophic antiphospholipid syndrome are diverse, which complicates timely diagnosis and, accordingly, adequate treatment. Goal: eliminate the difficulties encountered by practitioners in the diagnosis, differential diagnosis and treatment of catastrophic antiphospholipid syndrome, based on the analysis of literature data and on the example of a clinical case. Materials and methods: we did not find any studies on this issue in domestic sources, which led to the need to focus on literature data and a clinical example. Results: on the basis of the anamnesis of the disease, the results of clinical and additional research methods of the patient, a diagnosis of catastrophic antiphospholipid syndrome was established. Conclusions: for early diagnosis of catastrophic antiphospholipid syndrome, alertness is required when signs of disseminated intravascular coagulation and rapidly developing multiple organ failure occur.

scholarly journals Erythema nodosum as Leprosy reaction

2020 ◽  
Vol 96 (3) ◽  
pp. 68-74
Author(s):  
Viktoria G. Semenova ◽  
Ludmila L. Makarova ◽  
Arfenya E. Karamova
Keyword(s):  
Clinical Case ◽  
Erythema Nodosum ◽  
Clinical Manifestations ◽  
Complete Regression ◽  
Active Stage ◽  
Adequate Therapy ◽  
Dexamethasone Therapy

Purpose.To present a clinical case of leprosy exacerbation on the background of ongoing therapy. Materials and methods.A 52-year-old patient with a diagnosis of "lepromatous (cutaneous) leprosy, leprosy LL" (multi-bacterial leprosy, lepromatous form, active stage), has an exacerbation in the form of nodular erythema at 3.5 years after the start of treatment. Due to the exacerbation of the leprosy process, dexamethasone therapy was performed intravenously in a dose of 4 mg/ml 3.0 ml + 0.9% NaCl 200.0 ml daily No. 10. Results. An exacerbation was diagnosed leprosy nodular erythema. The prescription of adequate therapy led to a complete regression of clinical manifestations. Conclusion.The described case is presented in connection with the rarity of this dermatosis.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.

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