scholarly journals DAPSONE HYPERSENSITIVITY SYNDROME: A COMPLICATION OF DAPSONE THERAPY

2021 ◽  
pp. 7-8
Author(s):  
LAKSHMI NARASIMHA GUNTURU ◽  
SUNAINA V ◽  
REDDY SANTHOSH C ◽  
HARI KIRAN VN
Keyword(s):  
Adverse Effects ◽  
General Hospital ◽  
Treatment Regimen ◽  
Hypersensitivity Syndrome ◽  
Medication History ◽  
Dermatological Examination ◽  
Leprosy Patients ◽  
History Of ◽  
Laboratory Investigations ◽  
Multibacillary Leprosy

Dapsone is chemically sulfonamide with its leprostatic mechanism used in the treatment of Hansen’s disease. It is one of the safest drugs in leprosy patients. Apart from its safety, it is associated with various adverse effects such as hemolytic anemia, allergic dermatitis, agranulocytosis, methaemoglobinemia, and dapsone hypersensitivity syndrome (DHS). DHS typically presents with fever, skin eruptions, Jaundice, and hepatomegaly (organ involvement). We present a case of 35-year-old female attended to Government General Hospital with complaints of fever, skin rashes, and yellowish discoloration of the eyes. She had past medication history of dapsone taken for paucibacillary leprosy for 4 weeks. Her symptoms appeared after a month and become intolerable to dapsone. Laboratory investigations revealed hepatomegaly, anemic with jaundice. Based on dermatological examination, her diagnosis was confirmed as DHS. The drug was stopped and the patient was treated with drugs for the symptomatic cure. She was recovered from her condition and the multibacillary leprosy multidrug treatment regimen was continued without dapsone.

scholarly journals Trilostane Treatment of Canine Alopecia X in an American Pit Bull Terrier

2007 ◽  
Vol 76 (1) ◽  
pp. 113-120
Author(s):  
J. Kolevská ◽  
V. Brunclík ◽  
L. Bartošová ◽  
M. Svoboda
Keyword(s):  
Adverse Effects ◽  
Skin Biopsy ◽  
Treatment Option ◽  
Clinical Signs ◽  
Laboratory Findings ◽  
Hair Regrowth ◽  
Dermatological Examination ◽  
History Of ◽  
One Year ◽  
Hormone Imbalance

This paper describes the case of a one-year-old female American Pit Bull Terrier, presented with the history of progressive baldness. The initial clinical signs were demonstrated by symmetric, primarily non-pruritic alopecia that began in the perineal, genital, and ventral abdominal regions and propagated cranially to the thorax and to the neck. Based on physical and dermatological examination, laboratory findings, and results of skin biopsy, a hormone-responsive dermatosis was diagnosed. Once hypothyroidism and hyperadrenocorticism were ruled out, with the help of hormonal tests, the diagnosis was specified as alopecia X. The first treatment option recommended for the patient and subsequently completed was ovariohysterectomy. After three months, the owner reported improvement; the dog was almost covered with hair. The patient was presented again six months later, showing almost the same dermatological symptoms, which, however, were of a more striking character than before ovariohysterectomy. Again a series of hormonal tests was carried out. Considering the elevated basal and post-adrenocorticothropin stimulation progesterone concentrations, the final aetiology of the disease was determined as an adrenal sex hormone imbalance. Therefore trilostan therapy was initiated. The trilostan dosage of 8 mg/kg/day was divided and given 2 times daily. This treatment led to complete hair regrowth in the dog within four months. No adverse effects associated with trilostane were recognized.

Anaphylactic Reaction to a Dietary Supplement Containing Willow Bark

2003 ◽  
Vol 37 (6) ◽  
pp. 832-835 ◽  
Author(s):  
Joseph I Boullata ◽  
Patrick J McDonnell ◽  
Cynthia D Oliva
Keyword(s):  
Weight Loss ◽  
Adverse Effects ◽  
Dietary Supplements ◽  
Dietary Supplement ◽  
Anaphylactic Reaction ◽  
Medication History ◽  
Herbal Products ◽  
Initial Symptoms ◽  
History Of ◽  
Willow Bark

OBJECTIVE: To report a case of anaphylaxis resulting from the use of a willow bark–containing dietary supplement in a patient with a history of an aspirin allergy. CASE SUMMARY: A 25-year-old white woman presented to the emergency department of a community teaching hospital with anaphylaxis requiring epinephrine, diphenhydramine, methylprednisolone, and volume resuscitation to which she responded favorably. Medication history revealed that she had ingested 2 capsules of Stacker 2 (NVE Pharmaceuticals, Newton, NJ), a dietary supplement promoted for weight loss, prior to experiencing her initial symptoms. Among other active ingredients, this product contains willow bark. Of significance is that this patient also reported a history of allergy to acetylsalicylic acid. No other causes for anaphylaxis were identified. She continued to receive routine supportive care and the remaining hospital course was uncomplicated. DISCUSSION: Dietary supplements, including herbal products, are used by many individuals who consider them to be inherently safe despite limited regulatory oversight by the Food and Drug Administration. While there may be value to specific botanical ingredients, a potential for adverse effects also exists. The popular product consumed by our patient is used for weight loss and contains willow bark, a source of salicylates. Based on the Naranjo probability scale, it is probable that this case of anaphylaxis was due to this dietary supplement. CONCLUSIONS: The use of any willow bark–containing dietary supplement may present a risk of anaphylactic reaction to patients with a history of allergy to salicylates. Clinicians need to recognize the potential for adverse effects from dietary supplements.

scholarly journals Adverse effects of alternative therapy (minocycline, ofloxacin, and clofazimine) in multibacillary leprosy patients in a recognized health care unit in Manaus, Amazonas, Brazil

2013 ◽  
Vol 88 (2) ◽  
pp. 205-210 ◽  
Author(s):  
Marina Valente Maia ◽  
Maria da Graça Souza Cunha ◽  
Carolina Souza Cunha
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Skin Pigmentation ◽  
Alternative Therapy ◽  
Health Care Unit ◽  
Leprosy Patients ◽  
Treatment Abandonment ◽  
Multibacillary Leprosy ◽  
Monthly Dose

BACKGROUND: After the introduction of the multidrug therapy, there was a decline in the coefficients of prevalence and detection of new cases of leprosy. However, the records of drug resistance and relapses are threatening factors in leprosy control. Hence, new alternative schemes and monitoring of adverse effects to avoid treatment abandonment are important considerations. OBJECTIVE: Describe the side effects of a multidrug regimen containing minocycline, ofloxacin, and clofazimine in multibacillary leprosy patients. METHODS: We conducted a prospective, descriptive, and observational study with multibacillary patients, including cases of intolerance to standard MDT and relapses. The study was carried out at Fundação Alfredo da Matta (Alfredo da Matta Foundation), in Manaus, Amazonas, from April 2010 to January 2012. The patients received alternative therapy, which consisted of daily self-administered doses of 100mg of minocycline, 400 mg of ofloxacin, and 50mg of clofazimine and a supervised monthly dose of 300mg of clofazimine for six months, followed by eighteen months of daily doses of ofloxacin 400mg, clofazimine 50mg, and a supervised monthly dose of clofazimine 300mg. Results: Twenty-one cases were included. Mild and transitory side effects occurred in 33.3% of patients. Of the total episodes, 45.9% were attributed to ofloxacin and they included abdominal pain, nausea, vomiting, headache, and insomnia; 21.6% were due to clofazimine, with 100% of patients presenting skin pigmentation. The mean time for the development of adverse effects after beginning the therapy was 15.2 days. CONCLUSION: All patients tolerated the drugs well, and compliance was satisfactory, with no serious events. Unlike other standard MDT studies had shown, no treatment was stopped due to side effects. Nevertheless, patient follow-up and studies with bigger samples are necessary to guarantee the efficacy and safety of the alternative regimen as a second-line scheme in multi-drug therapy.

scholarly journals Correlation of Serum Vitamin D Receptor Level with Bacterial Index in Multibacillary Leprosy Patients at Sanglah General Hospital, Bali-Indonesia

2019 ◽  
Vol 12 (1) ◽  
pp. 469-472
Author(s):  
L. M. Rusyati ◽  
M. S. Adiguna ◽  
A. A. G. P. Wiraguna ◽  
N. M. D. Puspawati ◽  
P. Sudarsa
Keyword(s):  
Vitamin D ◽  
General Hospital ◽  
Vitamin D Receptor ◽  
Serum Vitamin ◽  
Study Participant ◽  
Serum Vitamin D ◽  
Leprosy Patients ◽  
The Mean ◽  
Multibacillary Leprosy ◽  
Bacterial Index

Leprosy cases were still a common problem in Indonesia. Even though Bali was not considered as a high epidemic region in Indonesia, new cases of multibacillary leprosy continuously appeared. Vitamin D and its receptor, Vitamin D Receptor (VDR) has a role in modulation of immune system against M. leprae. This study aimed to find correlation between blood VDR serum level with bacterial index of multibacillary leprosy patients. Study design using cross-sectional model conducted in Sanglah General Hospital involving 47 multibacillary leprosy patients taken consecutively from July-October 2017. The level of VDR was examined by ELISA method. Characteristic of study participant is 29 (61.7%) male patients and 18 (38.3%) female patients. The mean age of the patient was 38.83 years. The mean VDR level was 27.80 pg/dl. Spearman correlation test found that there is a strong negative correlation (r = - 0.954; p < 0.001) between plasma level of VDR with bacterial index in multibacillary patients. This result suggests that the lower the VDR level, the higher bacterial index in leprosy patients. This study emphasizes more the role of Vitamin D and its receptor in immunomodulation especially in leprosy infection.

Salicylate toxicity from chronic bismuth subsalicylate use

2020 ◽  
Vol 13 (11) ◽  
pp. e236929
Author(s):  
Sheliza Halani ◽  
Peter E Wu
Keyword(s):  
Emergency Department ◽  
Adverse Effects ◽  
Hearing Impairment ◽  
Reference Range ◽  
The Elderly ◽  
Intravenous Fluids ◽  
Over The Counter ◽  
Bismuth Subsalicylate ◽  
Salicylate Concentration ◽  
History Of

A 79-year-old man presented to the emergency department with a 1-week history of worsening confusion, falls and hearing impairment. An initial workup for infectious, metabolic and structural causes was unrevealing. However, further history discovered that he had been ingesting one to two bottles of Pepto-Bismol (bismuth subsalicylate) daily for gastro-oesophageal reflux symptoms. On his second day of admission, the plasma salicylate concentration was 2.08 mmol/L (reference range 1.10–2.20 mmol/L), despite no sources of salicylate in hospital. He was diagnosed with chronic salicylate toxicity and Pepto-Bismol use was discontinued. The patient was treated supportively with isotonic intravenous fluids only and plasma salicylate concentration fell to less than 0.36 mmol/L. Concurrently, all his symptoms resolved. This case highlights the potential adverse effects of over-the-counter medications. The diagnosis of chronic salicylate toxicity is challenging, specifically in the elderly and in undifferentiated presentations, as it can be missed if not suspected.

Disturbo della condotta alimentare, ecchimosi e carenza di vitamina C

2021 ◽  
Vol 24 (9) ◽  
pp. 273-276
Author(s):  
Anna Attico ◽  
Alessandra Iacono ◽  
Loretta Biserna ◽  
Sara Brandolini ◽  
Federico Marchetti
Keyword(s):  
Eating Disorder ◽  
Vitamin C ◽  
Rare Disease ◽  
Eating Habits ◽  
Coagulation Disorders ◽  
Vitamin C Deficiency ◽  
History Of ◽  
Laboratory Investigations

The paper presents the case of a 16-year-old girl with a 6-month history of eating disorder, restrictive subtype and diffuse ecchymosis. Anamnestic history and laboratory investigations allowed excluding coagulation disorders and making the diagnosis of vitamin C deficiency. Vitamin C deficiency is a rare disease but still sporadically described in children with unusual eating habits.

DEMOGRAPHIC PROFILE OF ACUTE FEBRILE ENCEPHALOPATHY CASES IN PEDIATRIC AGE GROUP PATIENTS: A STUDY FROM WESTERN RAJASTHAN

2021 ◽  
pp. 72-73
Author(s):  
Laxmi Rathore ◽  
P. K. Khatri ◽  
Saroj K. Meena ◽  
Archana Bora ◽  
Suneel Bhooshan
Keyword(s):  
Lower Class ◽  
Mental States ◽  
Clinical Feature ◽  
Female Ratio ◽  
Pediatric Age Group ◽  
History Of ◽  
Laboratory Investigations ◽  
Demographic Distribution ◽  
Viral Etiologies ◽  
Male To Female

Acute Febrile Encephalopathy is a clinical term used to describe patients presenting with short febrile illnesses with altered mental states. Demographic distribution plays an essential role in the diagnosis of viral etiologies. One hundred ve suspected AFE cases were enrolled in the study. A detailed history by predesigned performa and laboratory investigations was obtained for data collection. Viral etiology was diagnosed in 32 (30.48%) cases. The male to female ratio was 1.39:1. Total 56.25% of positive cases were from the lower class, 28.13% from the middle class, and 15.63% from the upper class. 24 (75%) cases from rural, while only 8 (25%) of the urban population showed viral etiologies. In 19 (59.4%) cases were either history of incomplete vaccination or not vaccinated, 13 (40.6%) cases had a history of complete immunization among positive cases. The predominant clinical feature was fever (100%) followed by seizures 66(62.86%), vomiting 37(35.24%), headache 14(13.33%), paresis in 16(15.24%) and altered sensorium in 29(27.62%), respectively. To conclude, the etiologic panorama of AFE varies with several factors such as time and demographical location, age, and immunization status. There is an urgent need to conduct more studies to prole the viral etiologies according to their prevalence in geographical areas so the treatment can be tailored accordingly and prophylaxis treatment or immunization can be boosted in the population at risk of getting the disease.

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