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Kazaoka A, Kumagai K, Matsushita J, Aida T, Kuwahara S, Aoki S, Ito K. Pathological changes in various organs in HLA-B*57:01 transgenic mice with abacavir-induced skin eruption. Toxicol Res 2024; 40:223-235. [PMID: 38525129 PMCID: PMC10959918 DOI: 10.1007/s43188-023-00220-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 03/26/2024] Open
Abstract
Several patients with cutaneous adverse drug reactions exhibit extracutaneous organ damages, and it becomes severe in a few patients resulting in death due to multiorgan failure. Understanding the sequential changes in various organs in patients with cutaneous eruption following drug administration will help understand disease onset and progression, aiding the development of prevention strategies and interventions. Therefore, we aimed to understand the effects of abacavir (ABC) on various organs in patients with ABC-induced eruptions by evaluating its effects in a mouse model. We found pathological changes in various organs of HLA-B*57:01 transgenic mice (B*57:01-Tg) following oral administration of ABC (20 mg/body/day). B*57:01-Tg exhibited a significant body weight decrease from day 1 of ABC administration, and reddening of the auricle was observed from day 5, and approximately 2/3 mice died by day 7. Histopathological examination revealed severe thymic atrophy after day 3, infiltration of inflammatory cells, predominantly lymphocytes with neutrophils, not only in the skin but also in the liver, kidney, and lung after day 5, and an increased number of lymphocytes with enlarged nuclei and granulocytic hematopoiesis were observed in the spleen after day 5. Blood chemistry revealed that albumin/globulin ratio was below 1.0 on day 5, reflecting a systemic inflammatory response, and the aspartate aminotransferase concentration rose to 193 ± 93.0 U/L on day 7, suggesting that cell damage may have occurred in various organs including liver accompanying inflammatory cell infiltration. These examinations of a mouse model of ABC-induced skin eruption show that disorders in various organs other than the skin should be considered and provide insights into the unexpected early systemic responses dependent on HLA-B*57:01. Supplementary Information The online version contains supplementary material available at 10.1007/s43188-023-00220-1.
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Affiliation(s)
- Akira Kazaoka
- Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-City, Chiba 260-8675 Japan
| | - Kazuyoshi Kumagai
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Junya Matsushita
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Tetsuo Aida
- Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Saki Kuwahara
- Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-City, Chiba 260-8675 Japan
| | - Shigeki Aoki
- Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-City, Chiba 260-8675 Japan
| | - Kousei Ito
- Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-City, Chiba 260-8675 Japan
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2
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Gottlieb M, Figlewicz MR, Rabah W, Buddan D, Long B. Drug reaction with eosinophilia and systemic symptoms: An emergency medicine focused review. Am J Emerg Med 2022; 56:1-6. [PMID: 35338896 DOI: 10.1016/j.ajem.2022.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/10/2022] [Accepted: 03/13/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug reaction associated with potentially severe morbidity and mortality. OBJECTIVE This narrative review evaluates the pathogenesis, diagnosis, and management of DRESS for emergency clinicians. DISCUSSION DRESS is a severe hypersensitivity reaction which can involve multiple organ systems, including the skin, lymphatic system, lungs, kidneys, and heart. Treatment is primarily supportive care combined with removal of the offending agent and initiation of corticosteroids. Additional options include cyclophosphamide, cyclosporine, intravenous immunoglobulin, and N-acetylcysteine. CONCLUSION It is important for the emergency clinician to be aware of the diagnosis and management of DRESS in order to best optimize care for these patients.
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Affiliation(s)
- Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, USA.
| | | | - Willeed Rabah
- Department of Emergency Medicine, Rush University Medical Center, USA
| | - Devon Buddan
- Department of Emergency Medicine, Rush University Medical Center, USA
| | - Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, USA
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3
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de Groot AC. Patch testing in Drug reaction with eosinophilia and systemic symptoms (DRESS): a literature review. Contact Dermatitis 2022; 86:443-479. [PMID: 35233782 DOI: 10.1111/cod.14090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 11/27/2022]
Abstract
The literature on positive patch test results in drug reaction with eosinophilia and systemic symptoms (DRESS) is reviewed. 105 drugs were identified that have together caused 536 positive patch tests in 437 patients suffering from DRESS. By far most reactions (n=145) were caused by carbamazepine, followed by amoxicillin, isoniazid, phenytoin, ethambutol, fluindione, phenobarbital, rifampicin, and ceftriaxone; 43 drugs each caused a single case only. The drug classes causing the highest number of reactions are anticonvulsants (39%), beta-lactam antibiotics (20%), antituberculosis agents (11%), non-beta-lactam antibiotics (6%) and iodinated contrast media (5%). The sensitivity of patch testing (percentage of positive reactions) is high for anticonvulsants (notably carbamazepine), beta-lactam antibiotics (notably amoxicillin) and possibly iodinated contrast media. Allopurinol and sulfasalazine frequently cause DRESS, but never give positive patch tests. Patch testing in DRESS appears to be safe, although mild recurrence of DRESS symptoms, mostly skin reactions, may not be rare. Multiple drug hypersensitivity was found to occur in 16% of all patients, but it is argued that the true frequency is (far) higher. Clinical aspects of DRESS, including diagnosing the disease and identifying culprit drugs (patch tests, intradermal tests, in vitro tests, challenge tests) are also provided, emphasizing the role of patch testing. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anton C de Groot
- dermatologist np Schipslootweg 5, 8351, HV, Wapserveen, The Netherlands
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4
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Naveed S, Urrutia V, Kaur L, Marshall J, Malik S. Systemic Adverse Reactions to Psychotropic Medications: What Do We Need to Know? Psychiatr Ann 2021. [DOI: 10.3928/00485713-20210803-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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5
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Hayashi M, Hamdy DA, Mahmoud SH. Applications for pharmacogenomics in pharmacy practice: A scoping review. Res Social Adm Pharm 2021; 18:3094-3118. [PMID: 34474980 DOI: 10.1016/j.sapharm.2021.08.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/19/2021] [Accepted: 08/18/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Pharmacogenomics (PGx) can provide valuable pharmacokinetic and pharmacodynamic information for the pharmacist's assessment of drug therapy, especially within medication therapy management (MTM) services. However, no review has comprehensively mapped the pharmacists' use of PGx in practice-based research. Doing so would allow future researchers, practitioners, and policy-makers to identify the ideal populations and settings for PGx implementation within the pharmacy. OBJECTIVE The purpose of this review is to identify the evidence to date of PGx use in pharmacy practice. METHODS A scoping review was conducted to find all studied non-oncologic pharmacy practices incorporating PGx testing. Search terms were applied to 5 databases and relevant journals. Characteristics of patients, pharmacy settings, genetic tests, and outcomes were summarized to determine models most likely to benefit patients. RESULTS The search identified 43 studies on the use of PGx by pharmacists published between 2007 and 2020. CYP2C19 testing with antiplatelets was the most studied model, found in both community and institutional settings. It also was the most actionable test: approximately 30% of patients have polymorphisms indicating a need for alternative antiplatelets, and identifying these patients can reduce morbidity and mortality by more than 50%. As technology shifts, broader studies using multi-gene panel tests within MTM demonstrate an approximate 50% decrease in emergency visits and hospitalizations in elderly polypharmacy patients. Clinical benefit or drug-gene interactions are also found in other cardiovascular, psychiatric, analgesic, and gastrointestinal indications. No evaluations of actual costs or of pharmacist prescribing within pharmacy-based PGx have been performed. Facilitators towards successful PGx implementation included pharmacist education, collaboration with other healthcare providers, and the use of clinical decision software. CONCLUSIONS Pharmacogenomic testing has demonstrated feasibility and improved medication outcomes in pharmacy practice, including in the community pharmacy. Further PGx research should be directed towards pharmacist prescribing, pharmacist education, and pharmacoeconomics.
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Affiliation(s)
- Meagan Hayashi
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada.
| | - Dalia A Hamdy
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada; AbEx Health Services LTD, Fort Saskatchewan, Alberta, Canada.
| | - Sherif Hanafy Mahmoud
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada.
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6
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Abstract
Toxic epidermal necrolyses represent a severe epidermolytic reaction characterized by cutaneous erythema and target lesions affecting >30% of the body surface, skin, and mucous membranes. Ulcerative lesions on the labial mucosa may evolve during healing, resulting in rare complications, such as lip adhesions. This report shows the successful treatment of a lip synechia resulting from the healing of mucosal lesions in a patient with toxic epidermal necrolysis caused by the use of Lamotrigine and Ibuprofen. Although the treatment of the presented lip synechia was simple, this sequela can be avoided by measures such as hydration, hygiene and lip lubrication.
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Sukasem C, Pratoomwun J, Satapornpong P, Klaewsongkram J, Rerkpattanapipat T, Rerknimitr P, Lertpichitkul P, Puangpetch A, Nakkam N, Konyoung P, Khunarkornsiri U, Disphanurat W, Srisuttiyakorn C, Pattanacheewapull O, Kanjanawart S, Kongpan T, Chumworathayi P, Saksit N, Bruminhent J, Tassaneeyakul W, Chantratita W, Pirmohamed M. Genetic Association of Co-Trimoxazole-Induced Severe Cutaneous Adverse Reactions Is Phenotype-Specific: HLA Class I Genotypes and Haplotypes. Clin Pharmacol Ther 2020; 108:1078-1089. [PMID: 32452529 DOI: 10.1002/cpt.1915] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 05/15/2020] [Indexed: 12/17/2022]
Abstract
Co-trimoxazole (CTX) causes various forms of severe cutaneous adverse reactions (SCARs). This case-control study was conducted to investigate the involvement between genetic variants of human leukocyte antigen (HLA) and CYP2C9 in CTX-induced SCARs, including Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) in Thai patients. Thirty cases of CTX-induced SCARs were enrolled and compared with 91 CTX-tolerant controls and 150 people from the general Thai population. Cases comprised 18 SJS/TEN and 12 DRESS patients. This study demonstrated that genetic association of CTX-induced SCARs was phenotype-specific. HLA-B*15:02 and HLA-C*08:01 alleles were significantly associated with CTX-induced SJS/TEN, whereas the HLA-B*13:01 allele was significantly associated with CTX-induced DRESS. In addition, a significant higher frequency of HLA-A*11:01-B*15:02 and HLA-B*13:01-C*03:04 haplotypes were detected in the group of CTX-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and DRESS cases, respectively. Genetic association of CTX-induced SCARs is phenotype-specific. Interestingly, these association was observed only in HIV-infected patients but not in non-HIV-infected patients.
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Affiliation(s)
- Chonlaphat Sukasem
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, Thailand.,The Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group
| | - Jirawat Pratoomwun
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, Thailand
| | - Patompong Satapornpong
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, Thailand.,Division of General Pharmacy Practice, Department of Pharmaceutical Care, Faculty of Pharmacy, Rangsit University, Pathum Thani, Thailand
| | - Jettanong Klaewsongkram
- The Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group.,Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Ticha Rerkpattanapipat
- The Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group.,Division of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pawinee Rerknimitr
- The Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group.,Division of Dermatology, Department of Medicine, Faculty of Medicine, Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Pattamon Lertpichitkul
- The Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group.,Division of Dermatology, Department of Medicine, Faculty of Medicine, Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Apichaya Puangpetch
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, Thailand
| | - Nontaya Nakkam
- Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Wareeporn Disphanurat
- The Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group.,Division of Dermatology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Chutika Srisuttiyakorn
- The Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group.,Division of Dermatology, Department of Medicine, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | | | - Thachanan Kongpan
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Thailand
| | - Pansu Chumworathayi
- Pharmacy Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand
| | - Niwat Saksit
- School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | - Jackrapong Bruminhent
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Wasun Chantratita
- Genomic Medicine Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Munir Pirmohamed
- Department of Molecular and Clinical Pharmacology, The Royal Liverpool, Broadgreen University Hospitals NHS Trust, MRC Centre for Drug Safety Science, Liverpool Health Partners, University of Liverpool, Liverpool, UK
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8
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Menteşoğlu D, Doğan Günaydın S, Ersoy‐Evans S. Drug reaction with eosinophilia and systemic symptoms syndrome induced by apixaban. Dermatol Ther 2020; 33:e13719. [DOI: 10.1111/dth.13719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Dilek Menteşoğlu
- Department of Dermatology and Venereology Hacettepe University, School of Medicine Ankara Turkey
| | - Sibel Doğan Günaydın
- Department of Dermatology and Venereology Hacettepe University, School of Medicine Ankara Turkey
| | - Sibel Ersoy‐Evans
- Department of Dermatology and Venereology Hacettepe University, School of Medicine Ankara Turkey
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9
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Abstract
Drug eruptions are among the great masqueraders that sometimes cause diagnostic challenges in clinical practice. Pharmacologic agents may induce skin changes, sharing the same pathophysiologic mechanisms of specific dermatoses, or inducing drug eruptions with different pathologic mechanisms that have similar clinical presentations. The former conditions are usually called drug-induced skin diseases, whereas the latter conditions are termed "dermatosis-like drug eruptions." Both types are great imitators in dermatologic practice and can be easily misdiagnosed as other diseases or lead to unrecognized causative agents.
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Affiliation(s)
- Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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10
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Masuka JT, Muzopambwa G, Khoza S, Chibanda D. An Interesting Case of Carbamazepine-Induced Stevens-Johnson Syndrome. DRUG SAFETY - CASE REPORTS 2018; 6:1. [PMID: 30535610 PMCID: PMC6288101 DOI: 10.1007/s40800-018-0095-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A 29-year-old Black female patient was admitted to a psychiatric ward with symptoms of major depressive disorder with psychosis. The patient was started on amitriptyline 50 mg/day and haloperidol 10 mg/day. On day 4 post-admission, the preferred first-line antidepressant, fluoxetine, became available and the patient was switched from amitriptyline to fluoxetine 20 mg/day. On the same day, the dose of haloperidol was reduced to 5 mg/day. Thirteen days post-initiation of these medications the patient became talkative, associated with emotional lability, an expansive mood, irritability and restlessness. The working diagnosis was changed to bipolar affective disorder in the manic phase. Fluoxetine was discontinued and carbamazepine 600 mg/day was added to the patient's treatment regimen. Her manic symptoms started to resolve; however, 14 days post-initiation of carbamazepine, the patient had a fever; itchy, discharging eyes; respiratory distress; generalised symmetrical erythematosus rash; buccal ulceration; and conjunctival injection with difficulty opening her eyes. Carbamazepine was immediately discontinued and the patient received intravenous fluid resuscitation. The patient recovered considerably after 12 days of symptomatic and supportive management, and was transferred back to the psychiatric ward for the continuation of bipolar disorder management. Lithium therapy was instituted and the patient was subsequently discharged. Using the Algorithm of Drug causality for Epidermal Necrolysis (ALDEN) Stevens-Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN) drug causality scoring system, carbamazepine and fluoxetine were evaluated as 'very probable' and 'possible' causes of SJS, respectively, in this patient. Fluoxetine-induced SJS was considered on account of previous case reports, however no evidence of causality was found in this patient. Consecutive administration with a potential increase in carbamazepine due to inhibition of cytochrome P450 (CYP) 3A4 metabolism by fluoxetine was also not ruled out. A diagnosis of carbamazepine-induced SJS was made and was considered an idiosyncratic adverse drug reaction.
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Affiliation(s)
- Josiah Tatenda Masuka
- Division of Psychiatry, Harare Central Hospital, PO Box ST 14, Southerton, Harare, Zimbabwe.
| | - Garikai Muzopambwa
- Division of Psychiatry, Harare Central Hospital, PO Box ST 14, Southerton, Harare, Zimbabwe
| | - Star Khoza
- Department of Clinical Pharmacology, College of Health Sciences, University of Zimbabwe, PO Box A178, Avondale, Harare, Zimbabwe.,Discipline of Pharmacology and Clinical Pharmacy, School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa
| | - Dixon Chibanda
- Division of Psychiatry, Harare Central Hospital, PO Box ST 14, Southerton, Harare, Zimbabwe.,Department of Psychiatry, College of Health Sciences, University of Zimbabwe, PO Box A178, Avondale, Harare, Zimbabwe
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11
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Holfinger S, Roy A, Schmidt M. Stevens-Johnson Syndrome After Armodafinil Use. J Clin Sleep Med 2018; 14:885-887. [PMID: 29734973 DOI: 10.5664/jcsm.7132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/07/2017] [Indexed: 11/13/2022]
Abstract
ABSTRACT We present the case of a 21-year-old woman in whom Stevens-Johnson syndrome (SJS) developed after initiation of armodafinil. Although this rare and life-threatening reaction is listed on armodafinil's label, no cases have been reported in the literature. This case, in addition to an update of the drug's label after post-marketing research, both support the link between armodafinil and SJS. Providers should maintain a high clinical suspicion for SJS when starting therapy to minimize associated morbidity and mortality by discontinuing armodafinil at the onset of first symptoms.
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Affiliation(s)
| | - Asim Roy
- Ohio Sleep Medicine Institute, Dublin, Ohio
| | - Markus Schmidt
- Ohio Sleep Medicine Institute, Dublin, Ohio.,Center for Experimental Neurology, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
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12
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Eginli A, Shah K, Watkins C, Krishnaswamy G. Stevens-Johnson syndrome and toxic epidermal necrolysis. Ann Allergy Asthma Immunol 2017; 118:143-147. [PMID: 28153080 DOI: 10.1016/j.anai.2016.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 11/21/2016] [Accepted: 11/26/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Ariana Eginli
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kena Shah
- Division of Allergy and Clinical Immunology, Nova Southeastern University/Larkin Hospital, Miami, Florida
| | - Casey Watkins
- Department of Medicine, Wake Forest School of Medicine and the Wake Baptist Hospital, Winston Salem, North Carolina
| | - Guha Krishnaswamy
- Department of Medicine, Wake Forest School of Medicine and the Wake Baptist Hospital, Winston Salem, North Carolina; W.G. (Bill) Hefner VA Medical Center, Salisbury, North Carolina; Kernersville Health Care Center, Kernersville, North Carolina.
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13
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Abstract
DRESS syndrome is a cutaneous and systemic drug reaction with severe complications and a long course that can be fatal. Recognition may be difficult, and the condition is just rare enough that clinicians will eventually see it but may not be familiar with it. This review will focus on key elements to help clinicians with the challenges of recognition and differential diagnosis.
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Affiliation(s)
- Howard M Corneli
- Professor (Corneli), University of Utah School of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine, Salt Lake City, UT
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14
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Wolski TP, Blasick S, Blackford MG. The Case of the Previously Shaky, Unimmunized, Itchy Infant With Rash and Pancytopenia. Clin Pediatr (Phila) 2016; 55:1366-1368. [PMID: 26961688 DOI: 10.1177/0009922816629618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | | | - Martha G Blackford
- 1 Akron Children's Hospital, Akron, OH, USA.,2 Northeast Ohio Medical University, Rootstown, OH, USA
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15
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Tsankov N, Kazandjieva J, Darlenski R. The skin as a target organ in multisystemic diseases II. Clin Dermatol 2015; 33:509-11. [PMID: 26321395 DOI: 10.1016/j.clindermatol.2015.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Progress in medical science has given a new reading to the claim that the skin could be a mirror of the pathological changes found in the internal organs. The concept that we previously promoted is furthered in this issue; namely that the greatest part of skin diseases are systemic ones. In this issue we focus on another group of diseases with systemic involvement and skin manifestations. We review such inflammatory conditions as lichen planus, autoinflammatory syndromes, and pyoderma gangrenosum focusing on their systemic involvement. We have not missed such classic examples of systemic involvement as scleroderma. In this issue we have included two infectious diseases with multi-organ involvement: Lyme disease and Herpes simplex. In contrast to our previous work, we have also addressed neoplastic diseases - namely mycosis fungoides.
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Affiliation(s)
- Nikolai Tsankov
- Department of Dermatology and Venereology, Tokuda Hospital, Sofia, 51B Nikola Vaptsarov Blvd., 1407 Sofia, Bulgaria.
| | - Jana Kazandjieva
- Department of Dermatology and Venereology, Medical University, Sofia, 1 Saint Georgi Sofiiski Str., 1431 Sofia, Bulgaria
| | - Razvigor Darlenski
- Department of Dermatology and Venereology, Tokuda Hospital, Sofia, 51B Nikola Vaptsarov Blvd., 1407 Sofia, Bulgaria
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