scholarly journals Oral Involvements of Hypersensitivity Reactions to ChemotherapyDrugs in Immunocompromised Child Patient: A Case Report

2017 ◽  
Vol 1 ◽  
Author(s):  
Agam Ferry Erwana ◽  
Irna Sufiawati
Keyword(s):  
Case Report ◽  
Acute Otitis Media ◽  
Mitotic Rate ◽  
Chemotherapeutic Agents ◽  
Lymphocytic Leukemia ◽  
Comprehensive Treatment ◽  
Type I ◽  
Hypersensitivity Reactions ◽  
Good Treatment Outcome ◽  
Almost All

<p class="AbstractContent"><strong>Background:</strong> Hypersensitivity reactions (HSRs) may occur in children with cancer during the use of almost all chemotherapeutic drugs, commonly present with mild/moderate to severe clinical patterns.</p><p class="AbstractContent"><strong>Case report:</strong> A 7-year-old, male patient, was referred from the RSUP Hasan Sadikin Pediatric Department, with the diagnosis of Acute Lymphocytic Leukemia (ALL), acute otitis media and Toxic Epidermal Necrolysis (TEN) ec susp/ metrotreksat ec susp/ leucovorine. The patient was diagnosed with oral involvement related to anemia and TEN. Lesions of reddish black crusts manifested on upper and lower lips, and multiple red macules in labial and buccal mucosas. Oral lesions showed significant improvement after administration of comprehensive treatment including corticosteroid mixed ointment, antimitotic oral suspension and multivitamin.</p><p class="AbstractContent"><strong>Discussion:</strong> The mechanisms responsible for most HSRs, including drug-related are not known, as they have generally not been evaluated. Most reactions are of the type I category in the Gell and Coombs classification, but there also are instances of types II, III, and IV reactions caused by many of the antineoplastic agents. Oral involvements in children due to hypersensitivity reactions are likely to occurred because they are more susceptible to stomatotoxic effects of chemotherapeutic agents, possibly related to a higher epithelial mitotic rate.</p><strong>Conclusion:</strong> Knowledge of the different clinical presentations of chemotherapeutic agent’s hypersensitivity reactions ‘oral involvements can help to ensure a good treatment outcome, to improve the quality of patient care and to reduce healthcare costs.

Immediate reaction to ibrutinib amenable to oral desensitization

2021 ◽  
pp. 107815522110046
Author(s):  
Neelam A Phadke ◽  
Samantha O Luk ◽  
Ephraim P Hochberg ◽  
Aleena Banerji
Keyword(s):  
Maculopapular Rash ◽  
Chemotherapeutic Agents ◽  
Lymphocytic Leukemia ◽  
Hypersensitivity Reactions ◽  
First Line ◽  
Management Guidelines ◽  
Cutaneous Hypersensitivity ◽  
Ige Mediated ◽  
To Receive ◽  
Oral Desensitization

Introduction Although up to half of patients receiving chemotherapeutic agents develop hypersensitivity reactions to the same, desensitization protocols can induce temporary tolerance to allow patients to continue to receive first-line treatment. Approximately 25% of patients develop cutaneous hypersensitivity reactions to ibrutinib, but there are no published management guidelines. Case report We describe the case of a 71-year-old woman with chronic lymphocytic leukemia who developed a delayed maculopapular rash with lip tingling and swelling following ibrutinib therapy. Management and outcome We performed a novel 11-step desensitization procedure to ibrutinib allowing us to successfully induce tolerance against IgE-mediated symptoms in this patient. Discussion As indications for ibrutinib use expand and more patients present with IgE-mediated symptoms, we expect that this protocol will provide benefit for many such patients.

scholarly journals Trichodentoosseous syndrome: a case report and review of literature

2019 ◽  
Vol 5 (4) ◽  
pp. 20190039 ◽  
Author(s):  
Rohan Jagtap ◽  
Raghd Alansari ◽  
Axel Ruprecht ◽  
Deeba Kashtwari
Keyword(s):  
Case Report ◽  
Incidental Finding ◽  
Treatment Plan ◽  
Cone Beam Ct ◽  
Amelogenesis Imperfecta ◽  
Cone Beam ◽  
Comprehensive Treatment ◽  
Type I ◽  
Radiographic Findings ◽  
Osseous Dysplasia

Trichodentoosseous (TDO) syndrome is a rare autosomal dominant condition characterized by various dental and non-dental findings such as taurodontism, amelogenesis imperfecta, osseous dysplasia, mandibular prognathism, curly hair, dysplastic nails, which may be symptomatic or asymptomatic. TDO syndrome is divided into three subtypes that helps to categorize different features seen in patients. There are very few cases reported in the literature of TDO syndrome. We present a case of a young adult male showing interesting Type I and II clinical and radiographic findings of the TDO syndrome. Amelogenesis imperfecta hypomaturation-hypoplastic type and TDO syndrome overlaps in their dental findings such as taurodontism and enamel hypoplasia and makes the diagnosis of TDO crucial. TDO syndrome was noted as an incidental finding on cone beam CT. This case report highlights the pathognomonic radiographic findings, treatment plan, and the clues to diagnosis this rare disorder. Management of TDO requires a proper diagnosis, multidisciplinary approach with comprehensive treatment plan including periodic follow up. Knowledge of this condition along with thorough interpretation of the entire cone beam CT volume are critical to understand this syndrome better due to its rarity.

scholarly journals Management of a Type I Hypersensitivity Reaction to IV Etoposide in a Woman with a Yolk Sac Tumor: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-2
Author(s):  
David Starks ◽  
Deborah Prinz ◽  
Amy Armstrong ◽  
Lindsay Means ◽  
Steven Waggoner ◽  
...  
Keyword(s):  
Case Report ◽  
Gynecologic Oncology ◽  
Yolk Sac ◽  
Yolk Sac Tumor ◽  
Type I ◽  
Hypersensitivity Reactions ◽  
Etoposide Phosphate ◽  
Type I Hypersensitivity ◽  
Substitute Drug ◽  
Severe Patient

Type I hypersensitivity reactions to intravenous administration of etoposide are extremely rare. Etoposide is an essential component of several chemotherapy regimens used in gynecologic oncology, and discontinuation of this drug during a course of treatment should only be due to severe patient intolerance. We report the successful use of intravenous etoposide phosphate as a substitute drug in a patient with a yolk sac tumor who manifested a Type I hypersensitivity to intravenous etoposide. The patient ultimately completed all 4 cycles of bleomycin, etoposide, cisplatin (BEP) using etoposide phosphate as a substitute drug.

scholarly journals Fixed drug eruption and anaphylaxis induced concurrently by erdosteine: a case report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Da Woon Sim ◽  
Ji Eun Yu ◽  
Young-Il Koh
Keyword(s):  
Case Report ◽  
Drug Eruption ◽  
Provocation Test ◽  
Skin Lesions ◽  
Laryngeal Edema ◽  
Type I ◽  
Hypersensitivity Reactions ◽  
Fixed Drug Eruption ◽  
Fixed Drug ◽  
Drug Provocation Test

Abstract Background Erdosteine is used as a mucolytic agent and has a low incidence of adverse drug reactions, most of which are gastrointestinal and mild. Moreover, drug antigens rarely induce multiple simultaneous immunologic reactions. Only one previous case report has demonstrated hypersensitivity reaction induced by erdosteine. Here, we report a case of fixed drug eruption and anaphylaxis, which were concurrently induced by erdosteine. The association between the symptoms and erdosteine was proven by a drug provocation test. Case presentation A 35-year-old woman presented with recurrent angioedema and pruritic rash on the hands, which developed within 2 h following the administration of drugs, including erdosteine, for acute upper respiratory infection. Her rash was characterized by well-defined erythematous plaques, which recurred at the same site following the administration of the medications. She also experienced angioedema of the lips. Fixed drug eruption was considered after excluding other possible causes for the presented skin lesions. A drug provocation test confirmed that fixed drug eruption on both hands had occurred after administration of erdosteine, suggesting that erdosteine was the cause of the allergic reaction. However, she also experienced angioedema, isolated wheal, and laryngeal edema; thus, IgE-mediated type I hypersensitivity could also be concurrently occurring with the fixed drug eruption. Conclusions We report about a patient who was diagnosed with two different hypersensitivity reactions concurrently induced by erdosteine. We also demonstrate that patients may exhibit multiple simultaneous symptoms that usually arise from overlapping of different hypersensitivity mechanisms. Physicians should be aware of the possibility that some patients who are allergic to certain drugs could exhibit several symptoms caused by different mechanisms of hypersensitivity reactions simultaneously.

Paraneoplastic Pemphigus in A Patient with Chronic Lymphocytic Leukemia: A Case Report

2018 ◽  
Vol 02 (03) ◽  
pp. 84-88
Author(s):  
Arif Kus ◽  
Abdulkerim Yildiz ◽  
Betul Erdem ◽  
Murat Albayrak ◽  
Cigdem Pala Ozturk ◽  
...  
Keyword(s):  
Case Report ◽  
Chronic Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Paraneoplastic Pemphigus

Surgical Repair of Type I Truncus Arteriosus 7 Years After Pulmonary Artery Banding: A case Report.

1998 ◽  
Vol 48 (3) ◽  
pp. 215-218
Author(s):  
Masao Suzuki ◽  
Akio Ohtaki ◽  
Shigeru Ohki ◽  
Takashi Ibe ◽  
Jun Murakami ◽  
...  
Keyword(s):  
Case Report ◽  
Pulmonary Artery ◽  
Surgical Repair ◽  
Pulmonary Artery Banding ◽  
Truncus Arteriosus ◽  
Type I

MARKED FIRST-DEGREE ATRIOVENTRICULAR BLOCK ASSOCIATED WITH PSEUDO-PACEMAKER SYNDROME: A CASE REPORT

2019 ◽  
pp. 199-206
Author(s):  
О. З. Скакун ◽  
С. В. Федоров ◽  
О. С. Вербовська ◽  
І. З. Твердохліб
Keyword(s):  
Case Report ◽  
Atrioventricular Block ◽  
Heart Block ◽  
Pacemaker Implantation ◽  
Rare Condition ◽  
Permanent Pacemaker ◽  
Type I ◽  
Atrial Contraction ◽  
General Weakness ◽  
Pacemaker Syndrome

Distinctive atrioventricular type I heart block is diagnosed when the PQ interval is 0.30 s. or more. Prolongation of the PQ interval more than 0.50 s. is a very rare condition. Usually it is associated with a pseudo-pacemaker syndrome. The last one manifests itself with dizziness, syncope, general weakness, shortness of breath upon physical exertion, cough, seizures, cold sweat, a feeling of pulsation in the head, neck and abdomen, a headache, paroxysmal nocturnal dyspnea, swelling of the lower extremities, tachypnea and jugular venous pulsation. The P wave appears immediately after the previous QRS complex. Atrial contraction occurs at the moment when the ventricles don’t relax after the previous contraction; due to the fact that pressure in the ventricles at this moment is higher than in the atria, the tricuspid and mitral valves remains closed. During the atrial contraction, most of the blood is ejected not into the ventricles, but backward into the pulmonary veins from the left atrium and into the venae cavae from the right atrium. Also, an atrial kick is absent which results in a less ventricular filling. There is increased pressure in the atria leading to their distension and excessive secretion of the atrial natriuretic peptide. A case report of the distinctive atrioventricular type I heart block associated with the pseudo-pacemaker syndrome is described. The patient suffered from a pre-syncope, short-term dizziness during the previous two days, tinnitus, general weakness, feeling of pulsation in the abdomen, neck, head, which interfered with his sleep. He developed these complaints after an infectious disease, which manifested as a runny nose and sore throat. In this patient, an extremely prolonged PQ interval up to 0.70 s. was observed. Also, episodes of Mobitz I and Mobitz type II atrioventricular block were detected. During the monitoring of patient state, the interval PQ was gradually shortening, and in 1 month it reached the normаl duration. It can be assumed that in the case of distinctive atrioventricular type I heart block, a significant prolongation of the refractory period in the rapid pathways of the AV-node plays a key role in the pathogenesis of this condition. According to the recommendations of the ACC/AHA (1998), for patients with distinctive atrioventricular type I heart block accompanied by the pseudo-pacemaker syndrome and documented alleviation of symptoms with temporary AV pacing, the pacemaker implantation should be considered (IIaB). The implantation of dual chamber pacemaker may reduce symptoms and lead to an improvement in the functional state of patients, in whom shortening of the interval between atrial and ventricular contractions improves hemodynamics. For asymptomatic patients with the PQ interval of ≥ 0.30 s, pacemaker is not recommended. The distinctive atrioventricular type I heart block in patients with pseudo-pacemaker syndrome is a rare condition and often remains undiagnosed. But it may have a benign course with a gradual normalization of the PQ interval. Indications for permanent pacemaker implantation should be reviewed as this block may be completely reversible. A permanent pacemaker may be used in the case of absence of positive dynamics in a shortening of the PQ interval.    

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