scholarly journals A case report on angioedema induced by levofloxacin: an unexpected occurrence

2017 ◽  
Vol 6 (11) ◽  
pp. 2749
Author(s):  
Haiya J. Sheth ◽  
Shikha V. Sood ◽  
Rushin P. Patel ◽  
Supriya D. Malhotra
Keyword(s):  
Case Report ◽  
Respiratory Tract Infections ◽  
Oral Corticosteroid ◽  
Cross Reactivity ◽  
Beta Lactams ◽  
Provisional Diagnosis ◽  
Suspected Drug ◽  
Drug Induced ◽  
Pheniramine Maleate ◽  
Tract Infections

Angioedema is an abrupt swelling of the skin, mucous membrane, or both. It can be either food or drug induced. Drug induced Angioedema (allergic or non-allergic) is known with ACE inhibitors, NSAIDs, Beta-lactams. Levofloxacin is a well-tolerated, broad-spectrum fluoroquinolone commonly prescribed for urinary or respiratory tract infections. Common side effects with levofloxacin involve gastrointestinal tract. However, reports on Levofloxacin induced Angioedema are scarce. Hence, we report two cases of Levofloxacin induced Angioedema. In both the cases, patients developed swelling of face following ingestion of Tab. Levofloxacin 500 mg orally BD on previous day. Drug was prescribed for urinary or respiratory infection. After a provisional diagnosis of Levofloxacin induced Angioedema by the dermatologist, both the patients were asked to withdraw the drug immediately. The reaction was treated with Inj. Avil (Pheniramine maleate) 1 cc i.v. stat and Inj. Dexona (Dexamethasone) 2 cc i.v. stat in one patient whereas oral corticosteroid (Tab. Prednisolone 10mg orally OD with tapering dose) was used in second patient. Oral antihistaminics were also prescribed as per the necessity. Both patients recovered within 4-7 days. Both ADRs were uploaded via Vigiflow under Pharmacovigilance Programme of India (PvPI) with likely relationship between suspected drug and ADR. Incidence of Drug induced cutaneous ADRs (CADRs) in India is 2.85%. Instances of hypersensitivity or anaphylactic reactions with fluoroquinolones are much lesser and milder than with NSAIDs or Beta-lactams. These reactions are associated with quinolone-specific Ig E. Existence of cross reactivity with quinolones is also high. This property is due to a similar ring (4-oxo-1, 4-dihydroquinoline ring) possessed by all fluoroquinolones. This allergic angioedema confined to the skin can be treated with antihistaminics or glucocorticoids.

scholarly journals Risperidone induced pancytopenia: a case report

2021 ◽  
Vol 10 (8) ◽  
pp. 1016
Author(s):  
Nader M. Alrahili
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Case Reports ◽  
Internal Medicine Ward ◽  
Provisional Diagnosis ◽  
Drug Induced ◽  
First Case ◽  
Lymph Node Enlargement ◽  
Tract Infections ◽  
Irritable Mood

There are several case reports on hematological side effects after using antipsychotics in the literature. This case report could be the first case report of pancytopenia where laboratory work showed thrombocytopenia, lymphocytopenia, and neutropenia after using risperidone. It is about 14-year-old female presented with irritable mood and aggression started on Risperidone 0.75 mg every night. A few weeks later she developed frequent and recurrent urinary tract infections and heavy vaginal bleeding that lasted for 5 days and reoccurred twice in the same month. Patient was admitted to internal medicine ward to investigate the cause of bleeding. No signs of splenomegaly, hepatomegaly, or lymph node enlargement were observed. All immunological workup results were negative. Bone morrow showed normal cellularity with granulocytic hyperplasia, suggesting a peripheral cause that was most likely a drug-induced effect. A provisional diagnosis of drug-induced pancytopenia was established. These hematological side effects may make physician to be more careful while prescribing risperidone and to follow the guideline of regular lab work especially CBC.

Lithium-Induced Parathyroid Dysfunction: A Case Report and Review of the Literature

1993 ◽  
Vol 27 (9) ◽  
pp. 1040-1043 ◽  
Author(s):  
Jerry W. Taylor ◽  
Angela J. Bell
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Lithium Carbonate ◽  
Suspected Drug ◽  
Current Management ◽  
Therapy Discontinuation ◽  
Drug Induced ◽  
Parathyroid Dysfunction ◽  
Management Recommendations

OBJECTIVE: Twenty-six cases of lithium-induced hyperparathyroidism have been reported in the literature. This article describes an additional case that illustrates current management recommendations. DESIGN: Case report. Clinical presentation and proposed mechanisms of the suspected drug-induced effect are discussed. CONCLUSIONS: Serum calcium concentrations should be determined before and periodically during long-term lithium carbonate therapy. Discontinuation of therapy in patients who develop lithium-induced parathyroid dysfunction generally corrects calcium and parathyroid hormone concentrations. Surgery is indicated in patients with complications of hyperparathyroidism.

scholarly journals Influenza A: another cause of SIADH?

2018 ◽  
pp. bcr-2018-226154
Author(s):  
Simon Mifsud ◽  
Maria Alessandra Zammit ◽  
Ramon Casha ◽  
Claudia Fsadni
Keyword(s):  
Case Report ◽  
Respiratory Tract ◽  
Antidiuretic Hormone ◽  
Influenza A ◽  
Respiratory Tract Infections ◽  
Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Osmotic Stimulus ◽  
Tract Infections ◽  
Dilutional Hyponatraemia

The syndrome of inappropriate antidiuretic hormone (SIADH) secretion is a frequent cause of hyponatraemia. It is a dilutional hyponatraemia secondary to impaired urinary dilution in the absence of renal disease or any identifiable non-osmotic stimulus known to induce antidiuretic hormone secretion. SIADH can arise secondary to various respiratory tract infections; however, the association between SIADH and influenza A infection is described in only a few cases in the literature. The authors present a case report of influenza A that may have caused a profound SIADH-related hyponatraemia.

scholarly journals Drug Liver Injury Induced by Olmesartan Mediated by Autoimmune-Like Mechanism: A Case Report

2020 ◽  
Author(s):  
Manuel de la Torre-Aláez ◽  
Mercedes Iñarrairaegui
Keyword(s):  
Case Report ◽  
Liver Injury ◽  
Drug Exposure ◽  
Interesting Case ◽  
Suspected Drug ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Difficult Diagnosis ◽  
Histological Confirmation ◽  
The Relationship

Autoimmune hepatitis (AIH) was the first liver disease for which an effective therapeutic intervention was carried out, using prednisolone; its usefulness was demonstrated in several clinical trials. Nevertheless, AIH still remains a difficult diagnosis in some cases, because it is necessary to dismiss other possible diagnoses, and perhaps due to it being a heterogeneous disease. The relationship between drug-induced liver injury (DILI) and AIH is complex and not fully understood. There are three possible scenarios: (1) DILI with a strong immunoallergic component mimicking AIH; (2) AIH mimicking a DILI due to drug exposure and (3) AIH triggered by exposure to an offending drug (drug-induced AIH). Drug-induced AIH is well described and documented for some drugs such as nitrofurantoin and minocycline. Histologically distinguishing DILI from AIH remains a challenge. We present an interesting case report which met serologic criteria and histological confirmation to establish AIH, but discontinuation of a suspected drug resolved hypertransaminasaemia.

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