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Cardozo M, Parmar AS, Rueda Prada L, Shweta F. A Case of Oral-Vancomycin-Induced Rash in a Patient with Acute Kidney Injury. Infect Dis Rep 2023; 15:180-187. [PMID: 37102979 PMCID: PMC10137931 DOI: 10.3390/idr15020019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/01/2023] Open
Abstract
Clostridioides difficile infection (CDI) is one of the most common hospital-acquired infections. Its incidence has increased during the last decade in the community among individuals with no previous risk factors; however, morbidity and mortality are still considered high in elderly patients. Oral Vancomycin and Fidaxomicin are the first lines of treatment for CDI. The systemic bioavailability of oral Vancomycin is thought to be undetectable due to its poor absorption in the gastrointestinal tract; therefore, routine monitoring is not warranted. Only 12 case reports were found in the literature that described adverse reactions associated with oral Vancomycin and its related risk factors. We present a case of a 66-year-old gentleman with severe CDI and acute renal failure who was started on oral Vancomycin upon admission. On day five of treatment, he developed leukocytosis associated with neutrophilia, eosinophilia, and atypical lymphocytes, with no evidence of active infection. Three days later, he developed a pruritic maculopapular rash in more than 50% of his body surface area. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) was ruled out since the patient only had three inclusion criteria for this diagnosis. No clear inciting agent was found. Oral Vancomycin was stopped and supportive treatment was supplied for a presumed Vancomycin-induced allergic reaction. The patient had an excellent response, with complete resolution of the rash and leukocytosis in less than 48 h. By reporting this case, we want to raise awareness among clinicians to remember that, albeit rare, oral Vancomycin can be the cause of adverse drug reactions in patients with severe illnesses.
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Affiliation(s)
- Milena Cardozo
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
- Correspondence:
| | - Angadbir S. Parmar
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Libardo Rueda Prada
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Fnu Shweta
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Department of Infectious Diseases, Mayo Clinic Health System, Eau Claire, WI 54703, USA
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2
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Kitsos N, Cassimos D, Trypsianis G, Xinias I, Roilides E, Grivea I, Mantadakis E, Mavroudi A. Drug allergy evaluation in children with suspected mild antibiotic allergy. FRONTIERS IN ALLERGY 2022; 3:1050048. [PMID: 36569377 PMCID: PMC9784922 DOI: 10.3389/falgy.2022.1050048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/24/2022] [Indexed: 12/12/2022] Open
Abstract
Background Adverse antibiotic reactions caused by an immunological mechanism are known as allergic reactions. The percentage of reported antibiotic allergies is likely to differ from the one validated after a drug provocation test (DPT) with the culprit antibiotic. This study aimed to compare the percentage of children who were thought to be allergic to a certain antibiotic with those who have a true allergy, as confirmed by DPTs. We also validated Skin Prick Tests (SPTs) and Intradermal Tests (IDTs) by assessing their sensitivity and specificity, in diagnosing antibiotic allergies using DPT as the gold standard. Furthermore, we investigated epidemiological risk factors such as personal and family history of atopic disease and eosinophilia. Methods Children with a history of possible allergic reaction to an antibiotic underwent a diagnostic procedure that included: (1) Eosinophil blood count, (2) SPTs, (3) IDTs and (4) DPTs. The parameters were compared with Pearson's Chi-Square and Fisher's Exact Test. Several risk factors that were found significant in univariate analysis, such as personal and family history of atopic disease, and positive SPTs and IDTs were examined with multiple logistic regression analysis to see if they were related to a higher risk for a positive DPT. Results Semi-synthetic penicillin was the most common group of antibiotics thought to cause allergic reactions in this study. Overall, 123 children with a personal history of an adverse reaction to a certain antibiotic, were evaluated. In 87.8% of the cases, the symptoms had occurred several hours after administration of the culprit antibiotic. Both SPTs and IDTs had low sensitivity but high specificity. Moreover, they had a high positive predictive value (PPV). In contrast, eosinophilia was not recognized as a risk factor. Seventeen patients (13.8%) had a true antibiotic allergy, as confirmed by a positive DPT. A positive IDT was a strong predictor of a positive DPT, along with a positive personal and family history of atopy. Conclusion SPTs and IDTs are very reliable in confirming antibiotic allergy when found positive. A negative result of a SPT highly predicts a negative DPT. A positive IDT and a positive personal and family history of atopy were recognized as significant risk factors for antibiotic allergy.
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Affiliation(s)
- Nikolaos Kitsos
- 3rd Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece,Correspondence: Nikolaos Kitsos
| | - Dimitrios Cassimos
- Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Grigorios Trypsianis
- Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioannis Xinias
- 3rd Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Emmanouil Roilides
- 3rd Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioanna Grivea
- School of Health Sciences, University of Thessaly, Larisa, Greece
| | - Elpis Mantadakis
- Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Antigoni Mavroudi
- 3rd Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
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3
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Kang SY, Seo J, Kang HR. Desensitization for the prevention of drug hypersensitivity reactions. Korean J Intern Med 2022; 37:261-270. [PMID: 35123386 PMCID: PMC8925949 DOI: 10.3904/kjim.2021.438] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/19/2021] [Indexed: 11/27/2022] Open
Abstract
Drug desensitization is the temporary induction of tolerance to a sensitized drug by administering slow increments of the drug, starting from a very small amount to a full therapeutic dose. It can be used as a therapeutic strategy for patients with drug hypersensitivity when no comparable alternatives are available. Desensitization has been recommended for immunoglobulin E (IgE)-mediated immediate hypersensitivity; however, its indications have recently been expanded to include non-IgE-mediated, non-immunological, or delayed T cell-mediated reactions. Currently, the mechanism of desensitization is not fully understood. However, the attenuation of various intracellular signals in target cells is an area of active research, such as high-affinity IgE receptor (FcεRI) internalization, anti-drug IgG4 blocking antibody, altered signaling pathways in mast cells and basophils, and reduced Ca2+ influx. Agents commonly requiring desensitization include antineoplastic agents, antibiotics, antituberculous agents, and aspirin/nonsteroidal antiinflammatory drugs. Various desensitization protocols (rapid or slow, multi-bag or one-bag, with different target doses) have been proposed for each drug. An appropriate protocol should be selected with the appropriate concentration, dosage, dosing interval, and route of administration. In addition, the protocol should be adjusted with consideration of the severity of the initial reaction, the characteristics of the drug itself, as well as the frequency, pattern, and degree of breakthrough reactions.
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Affiliation(s)
- Sung-Yoon Kang
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon,
Korea
| | - Jeongmin Seo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Hye-Ryun Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul,
Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul,
Korea
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4
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Kirkwood BJ, Billing KJ. Membranous conjunctivitis from adverse drug reaction: Stevens–Johnson syndrome. Clin Exp Optom 2021; 94:236-9. [DOI: 10.1111/j.1444-0938.2010.00548.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Bradley J Kirkwood
- Department of Ophthalmology, Flinders Medical Centre, Adelaide, South Australia, Australia E‐mail:
| | - Kathryn J Billing
- Department of Ophthalmology, Flinders Medical Centre, Adelaide, South Australia, Australia E‐mail:
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5
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Taverner J, Ross L, Bartlett C, Luthe M, Ong J, Irving L, Smallwood N. Antimicrobial prescription in patients dying from chronic obstructive pulmonary disease. Intern Med J 2019; 49:66-73. [PMID: 29740931 DOI: 10.1111/imj.13959] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 04/10/2018] [Accepted: 05/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite rising antimicrobial resistance, treatment guidelines for chronic obstructive pulmonary disease (COPD) exacerbations are frequently ignored. Patients with terminal conditions are often prescribed antimicrobials despite the goal of care to reduce burdensome treatments. The appropriate use of antimicrobials in patients who die from an exacerbation of COPD is unknown. AIM To review antimicrobial prescription during the final admission in patients who died from an acute exacerbation of COPD. METHODS A retrospective medical record audit was performed for 475 patients who died over 12 years (2004-2015). Patients were analysed within three groups: Group 1 - pneumonia on chest radiograph, Group 2 - infective exacerbation of COPD +/- raised inflammatory markers (white cell count, C-reactive protein) and Group 3 - non-infective exacerbation of COPD. RESULTS A total of 221 patients died from COPD. The median age was 80 years, and 136 (60%) were male. Median respiratory function: forced expiratory volume in 1 s 0.8 L (41.0%), forced vital capacity 2.0 L (74.0%) and diffusing capacity for carbon monoxide 8 (40.5%). A total of 109 (49.3%) patients used home oxygen and 156 (70.6%) were ex-smokers. Of the cohort, 90.5% received antimicrobials. In Groups 1, 2 and 3, 68 (94.4%), 108 (92.3%) and 24 (75.0%) patients received antimicrobials respectively. Guideline-concordant therapy was administered to 31.7% of patients (Group 1: 79.2%, Group 2: 4.3%, Group 3: 25.0%), 60.2% of patients received ceftriaxone and 44.8% received azithromycin. The median duration of therapy was 4 days and 27.1% received antimicrobials at the time of death. CONCLUSION Antimicrobials are overprescribed, and non-guideline antimicrobials are overused in patients who die from COPD. Further education of medical staff, regular medication reviews and the use of disease severity scores or clinical pathways may improve antimicrobial stewardship.
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Affiliation(s)
- John Taverner
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Lauren Ross
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Claire Bartlett
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Marco Luthe
- Clinical Costing Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Jeffrey Ong
- Clinical Costing Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Louis Irving
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Natasha Smallwood
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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6
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Macrolide Allergic Reactions. PHARMACY 2019; 7:pharmacy7030135. [PMID: 31540456 PMCID: PMC6789826 DOI: 10.3390/pharmacy7030135] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/07/2019] [Accepted: 09/11/2019] [Indexed: 01/02/2023] Open
Abstract
Macrolides are antimicrobial agents that can be used to treat a variety of infections. Allergic reactions to macrolides occur infrequently but can include minor to severe cutaneous reactions as well as systemic life-threatening reactions such as anaphylaxis. Most reports of allergic reactions occurred in patients without prior exposure to a macrolide. Cross-reactivity among macrolides may occur due to the similarities in their chemical structures; however, some published literature indicates that some patients can tolerate a different macrolide. Most published reports detailed an allergic reaction to erythromycin. Desensitization protocols to clarithromycin and azithromycin have been described in the literature. The purpose of this article is to summarize macrolide-associated allergic reactions reported in published literature. An extensive literature search was conducted to identify publications linking macrolides to hypersensitivity reactions.
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Chastain DB, Hutzley VJ, Parekh J, Alegro JVG. Antimicrobial Desensitization: A Review of Published Protocols. PHARMACY 2019; 7:E112. [PMID: 31405062 PMCID: PMC6789802 DOI: 10.3390/pharmacy7030112] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/05/2019] [Accepted: 08/07/2019] [Indexed: 12/21/2022] Open
Abstract
Antimicrobial desensitization represents a last-line option for patients with no alternative therapies, where the benefits of this intensive process must outweigh the potential harm from drug exposure. The goal of antimicrobial desensitization procedures is to establish a temporary state of tolerance to drugs that may otherwise cause hypersensitivity reactions. While no universal antimicrobial desensitization protocols exist, this review critically analyzes previously published desensitization protocols. The purpose of this review is to provide a greater insight for clinicians and institutions to ensure desensitization procedures are efficacious while minimizing potential for patient harm. With an increasing rate of antimicrobial resistance and the critical need to preserve antimicrobial agents, desensitization may represent another option in our antimicrobial stewardship toolkit.
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Affiliation(s)
| | | | - Jay Parekh
- Roosevelt University College of Pharmacy, Schaumburg, IL 60173, USA
| | - Jason Val G Alegro
- Mount Sinai Hospital, Chicago, IL 60608, USA.
- Roosevelt University College of Pharmacy, Schaumburg, IL 60173, USA.
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Suss PH, Ribeiro VST, Cieslinski J, Kraft L, Tuon FF. Experimental procedures for decontamination and microbiological testing in cardiovascular tissue banks. Exp Biol Med (Maywood) 2019; 243:1286-1301. [PMID: 30614255 DOI: 10.1177/1535370218820515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPACT STATEMENT Sterility testing is a critical issue in the recovery, processing, and release of tissue allografts. Contaminated allografts are often discarded, increasing costs, and reducing tissue stocks. Given these concerns, it is important to determine the most effective methodology for sterility testing. This work provides an overview of microbiological methods for sampling and culturing donor grafts for cardiovascular tissue banking.
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Affiliation(s)
- Paula Hansen Suss
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
| | - Victoria Stadler Tasca Ribeiro
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
| | - Juliette Cieslinski
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
| | - Letícia Kraft
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
| | - Felipe Francisco Tuon
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil.,2 Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
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9
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Feng X, Ashley J, Zhou T, Sun Y. Fluorometric determination of doxycycline based on the use of carbon quantum dots incorporated into a molecularly imprinted polymer. Mikrochim Acta 2018; 185:500. [DOI: 10.1007/s00604-018-2999-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/09/2018] [Indexed: 11/28/2022]
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10
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de By TMMH, McDonald C, Süßner S, Davies J, Heng WL, Jashari R, Bogers AJJC, Petit P. Validation of microbiological testing in cardiovascular tissue banks: results of a quality round trial. Eur J Cardiothorac Surg 2018; 52:895-900. [PMID: 28605496 DOI: 10.1093/ejcts/ezx178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/23/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Surgeons needing human cardiovascular tissue for implantation in their patients are confronted with cardiovascular tissue banks that use different methods to identify and decontaminate micro-organisms. To elucidate these differences, we compared the quality of processing methods in 20 tissue banks and 1 reference laboratory. We did this to validate the results for accepting or rejecting tissue. We included the decontamination methods used and the influence of antibiotic cocktails and residues with results and controls. The minor details of the processes were not included. METHODS To compare the outcomes of microbiological testing and decontamination methods of heart valve allografts in cardiovascular tissue banks, an international quality round was organized. Twenty cardiovascular tissue banks participated in this quality round. The quality round method was validated first and consisted of sending purposely contaminated human heart valve tissue samples with known micro-organisms to the participants. The participants identified the micro-organisms using their local decontamination methods. RESULTS Seventeen of the 20 participants correctly identified the micro-organisms; if these samples were heart valves to be released for implantation, 3 of the 20 participants would have decided to accept their result for release. Decontamination was shown not to be effective in 13 tissue banks because of growth of the organisms after decontamination. Articles in the literature revealed that antibiotics are effective at 36°C and not, or less so, at 2-8°C. The decontamination procedure, if it is validated, will ensure that the tissue contains no known micro-organisms. CONCLUSIONS This study demonstrates that the quality round method of sending contaminated tissues and assessing the results of the microbiological cultures is an effective way of validating the processes of tissue banks. Only when harmonization, based on validated methods, has been achieved, will surgeons be able to fully rely on the methods used and have confidence in the consistent sterility of the tissue grafts. Tissue banks should validate their methods so that all stakeholders can trust the outcomes.
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Affiliation(s)
| | - Carl McDonald
- National Bacteriology Laboratory, NHS Blood and Transplant, Colindale, UK
| | - Susanne Süßner
- Austrian Red Cross, Blood Transfusion Service for Upper Austria, Linz, Austria
| | - Jill Davies
- Oxford Radcliffe Hospitals, NHS Trust, Oxford, UK
| | - Wee Ling Heng
- National Cardiovascular Homograft Bank, SingHealth Transplant Tissue Centre, Singapore
| | - Ramadan Jashari
- European Homograft Bank (EHB), St Jean Clinique, Brussels, Belgium
| | - Ad J J C Bogers
- Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, Netherlands
| | - Pieter Petit
- Foundation of European Tissue Banks, Berlin, Germany
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Stone C, Brown NJ. Angiotensin-converting Enzyme Inhibitor and Other Drug-associated Angioedema. Immunol Allergy Clin North Am 2018; 37:483-495. [PMID: 28687104 DOI: 10.1016/j.iac.2017.04.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Nonsteroidal antiinflammatory agents, β-lactam antibiotics, non-β lactam antibiotics, and angiotensin-converting enzyme inhibitors are the most common classes of drugs that cause angioedema. Drug-induced angioedema is known to occur via mechanisms mediated by histamine, bradykinin, or leukotriene, and an understanding of these mechanisms is crucial in guiding therapeutic decisions. Nonallergic angioedema occurs in patients with genetic variants that affect metabolism or synthesis of bradykinin, substance P, prostaglandins, or leukotrienes, or when patients are taking drugs that have synergistic mechanisms. The mainstay in treatment of nonallergic drug-induced angioedema is cessation of the offending agents.
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Affiliation(s)
- Cosby Stone
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South T-1218, Medical Center North, Nashville, TN 37232-2650, USA
| | - Nancy J Brown
- Department of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South D-3100, Medical Center North, Nashville, TN 37232, USA.
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12
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Pattern of adverse drug reactions in a regional pharmacovigilance center of a tertiary care teaching hospital. DRUGS & THERAPY PERSPECTIVES 2018. [DOI: 10.1007/s40267-017-0474-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Yaita K, Sakai Y, Masunaga K, Watanabe H. A Retrospective Analysis of Drug Fever Diagnosed during Infectious Disease Consultation. Intern Med 2016; 55:605-8. [PMID: 26984075 DOI: 10.2169/internalmedicine.55.5740] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To clarify the current situation concerning drug fever (DF) in Japan, we retrospectively analyzed patients undergoing infectious disease consultation at our institution. METHODS Between April 2014 and May 2015, we extracted the records of DF patients from among 388 patients who had obtained infectious disease consultations in Kurume University Hospital. We reviewed their medical charts and summarized the characteristics of DF. RESULTS This study included the records of 16 patients. Clinical signs (relative bradycardia, the duration of the drug administration before becoming febrile, and the interval between the discontinuation of a drug and the alleviation of a fever), and laboratory tests (varied white blood cell count, low level of C-reactive protein, and a mild elevation of transaminases) were compatible with those from previous reports. Among the drug-confirmed cases, five involved the use of glycopeptides (vancomycin: 3, teicoplanin: 2), which were considered to be uncommon causes, and the another five cases involved the use of β-lactams. In addition, the procalcitonin levels were either negative or low (≤0.25 ng/mL) in 10 of the 11 procalcitonin-measured cases. CONCLUSION Our findings demonstrated that glycopeptides, similar to β-lactams, may be the origin of DF. Furthermore, procalcitonin may be helpful in the diagnosis of DF, but only in combination with other detailed examinations.
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Affiliation(s)
- Kenichiro Yaita
- Department of Infection Control and Prevention, Kurume University School of Medicine, Japan
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Żukiewicz-Sobczak WA, Wróblewska P, Adamczuk P, Zwoliński J, Oniszczuk A, Wojtyła-Buciora P, Silny W. Drugs as important factors causing allergies. Postepy Dermatol Alergol 2015; 32:388-92. [PMID: 26759548 PMCID: PMC4692812 DOI: 10.5114/pdia.2014.44021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 04/29/2014] [Indexed: 01/15/2023] Open
Abstract
Medications can cause many adverse reactions, both non-immunologic and immunologic ones. Allergies can take many forms, allergic reactions include all types of reactions according to Gell and Coombs. Typically, allergic reactions to drugs are manifested by skin lesions such as maculopapular rash or urticaria and life-threatening systemic reactions such as anaphylaxis. Allergy to drugs is diagnosed based on medical history and a number of specific tests: skin tests, blood tests. In diagnosing the causes of anaphylaxis, the basophil activation test is used to exclude false negative and false positive results of skin tests and specific IgE levels. Allergic reactions to medications usually resolve themselves after discontinuation of the drug. Sometimes in the treatment anti-allergic drugs are used to inhibit the development of skin lesions. After observing any signs of drug allergy it is important to accurately diagnose the cause, since the subsequent exposure to the drug may lead to a strong anaphylactic reaction and consequently death.
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Affiliation(s)
- Wioletta A. Żukiewicz-Sobczak
- Pope John Paul II State School of Higher Education, Biala Podlaska, Poland. Rector of the School: Prof. Józef Bergier
| | - Paula Wróblewska
- Department of Allergology and Environmental Hazards, Institute of Rural Health, Lublin, Poland. Head of the Department: Wioletta A. Żukiewicz-Sobczak PhD
| | - Piotr Adamczuk
- Department of Allergology and Environmental Hazards, Institute of Rural Health, Lublin, Poland. Head of the Department: Wioletta A. Żukiewicz-Sobczak PhD
| | - Jacek Zwoliński
- Department of Allergology and Environmental Hazards, Institute of Rural Health, Lublin, Poland. Head of the Department: Wioletta A. Żukiewicz-Sobczak PhD
| | - Anna Oniszczuk
- Department of Inorganic Chemistry, Medical University of Lublin, Lublin, Poland. Head of the Department: Prof. Monika Waksmundzka-Hajnos
| | - Paulina Wojtyła-Buciora
- Department of Hygiene, Poznan University of Medical Sciences, Poznan, Poland. Head of the Department: Prof. Jerzy Marcinkowski MD, PhD
| | - Wojciech Silny
- Greater Allergy and Dermatology Center “Art Clinic”, Poznan, Poland. Head of the Department: Paweł Silny MD, PhD
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Wang Z, Mi T, Beier RC, Zhang H, Sheng Y, Shi W, Zhang S, Shen J. Hapten synthesis, monoclonal antibody production and development of a competitive indirect enzyme-linked immunosorbent assay for erythromycin in milk. Food Chem 2015; 171:98-107. [DOI: 10.1016/j.foodchem.2014.08.104] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 08/13/2014] [Accepted: 08/23/2014] [Indexed: 11/26/2022]
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Kim MH, Lee JM. Diagnosis and management of immediate hypersensitivity reactions to cephalosporins. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2014; 6:485-95. [PMID: 25374747 PMCID: PMC4214968 DOI: 10.4168/aair.2014.6.6.485] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 06/03/2014] [Indexed: 12/16/2022]
Abstract
Cephalosporins can cause a range of hypersensitivity reactions, including IgE-mediated, immediate reactions. Cephalosporin allergy has been reported with use of a specific cephalosporin, as a cross-reaction between different cephalosporins or as a cross-reaction to other β-lactam antibiotics. Unlike penicillins, the exact allergenic determinants of cephalosporins are less well understood and thus, standardized diagnostic skin testing is not available. Nevertheless, skin testing with diluted solutions of cephalosporins can be valuable in confirming IgE-mediated hypersensitivity reactions. In vitro tests are in development using recent technological advances and can be used as complementary tests. However, they are not commonly used because of their reduced sensitivity and limited availability. In selected cases of inconclusive results in both skin tests and IgE assays, a graded challenge or induction of drug tolerance with the implicated cephalosporin should be performed.
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Affiliation(s)
- Min-Hye Kim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jong-Myung Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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Yildirim P, Majnarić L, Ekmekci OI, Holzinger A. Knowledge discovery of drug data on the example of adverse reaction prediction. BMC Bioinformatics 2014; 15 Suppl 6:S7. [PMID: 25079450 PMCID: PMC4158658 DOI: 10.1186/1471-2105-15-s6-s7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Antibiotics are the widely prescribed drugs for children and most likely to be related with adverse reactions. Record on adverse reactions and allergies from antibiotics considerably affect the prescription choices. We consider this a biomedical decision-making problem and explore hidden knowledge in survey results on data extracted from a big data pool of health records of children, from the Health Center of Osijek, Eastern Croatia. RESULTS We applied and evaluated a k-means algorithm to the dataset to generate some clusters which have similar features. Our results highlight that some type of antibiotics form different clusters, which insight is most helpful for the clinician to support better decision-making. CONCLUSIONS Medical professionals can investigate the clusters which our study revealed, thus gaining useful knowledge and insight into this data for their clinical studies.
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Affiliation(s)
- Pinar Yildirim
- Department of Computer Engineering, Faculty of Engineering & Architecture,
Okan University, Istanbul, Turkey
| | | | - Ozgur Ilyas Ekmekci
- Department of Computer Engineering, Faculty of Engineering & Architecture,
Okan University, Istanbul, Turkey
| | - Andreas Holzinger
- Institute for Medical Informatics, Statistics & Documentation, Medical
University of Graz, Graz, Austria
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Lin YF, Yang CH, Sindy H, Lin JY, Rosaline Hui CY, Tsai YC, Wu TS, Huang CT, Kao KC, Hu HC, Chiu CH, Hung SI, Chung WH. Severe Cutaneous Adverse Reactions Related to Systemic Antibiotics. Clin Infect Dis 2014; 58:1377-85. [DOI: 10.1093/cid/ciu126] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Paul L, Robinson KM. Capture and documentation of coded data on adverse drug reactions: an overview. Health Inf Manag 2014; 41:27-36. [PMID: 23705134 DOI: 10.1177/183335831204100304] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Allergic responses to prescription drugs are largely preventable, and incur significant cost to the community both financially and in terms of healthcare outcomes. The capacity to minimise the effects of repeated events rests predominantly with the reliability of allergy documentation in medical records and computerised physician order entry systems (CPOES) with decision support such as allergy alerts. This paper presents an overview of the nature and extent of adverse drug reactions (ADRs) in Australia and other developed countries, a discussion and evaluation of strategies which have been devised to address this issue, and a commentary on the role of coded data in informing this patient safety issue. It is not concerned with pharmacovigilance systems that monitor ADRs on a global scale. There are conflicting reports regarding the efficacy of these strategies. Although in many cases allergy alerts are effective, lack of sensitivity and contextual relevance can often induce doctors to override alerts. Human factors such as user fatigue and inadequate adverse drug event reporting, including ADRs, are commonplace. The quality of and response to allergy documentation can be enhanced by the participation of nurses and pharmacists, particularly in medication reconciliation. The International Classification of Diseases (ICD) coding of drug allergies potentially yields valuable evidence, but the quality of local and national level coded data is hampered by under-documenting and under-coding.
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Affiliation(s)
- Lindsay Paul
- School of Public Health, Faculty of Health Sciences, La Trobe University, Bundoora VIC 3086, Australia.
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20
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Drug-induced acute myocardial infarction: identifying 'prime suspects' from electronic healthcare records-based surveillance system. PLoS One 2013; 8:e72148. [PMID: 24015213 PMCID: PMC3756064 DOI: 10.1371/journal.pone.0072148] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 07/05/2013] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Drug-related adverse events remain an important cause of morbidity and mortality and impose huge burden on healthcare costs. Routinely collected electronic healthcare data give a good snapshot of how drugs are being used in 'real-world' settings. OBJECTIVE To describe a strategy that identifies potentially drug-induced acute myocardial infarction (AMI) from a large international healthcare data network. METHODS Post-marketing safety surveillance was conducted in seven population-based healthcare databases in three countries (Denmark, Italy, and the Netherlands) using anonymised demographic, clinical, and prescription/dispensing data representing 21,171,291 individuals with 154,474,063 person-years of follow-up in the period 1996-2010. Primary care physicians' medical records and administrative claims containing reimbursements for filled prescriptions, laboratory tests, and hospitalisations were evaluated using a three-tier triage system of detection, filtering, and substantiation that generated a list of drugs potentially associated with AMI. Outcome of interest was statistically significant increased risk of AMI during drug exposure that has not been previously described in current literature and is biologically plausible. RESULTS Overall, 163 drugs were identified to be associated with increased risk of AMI during preliminary screening. Of these, 124 drugs were eliminated after adjustment for possible bias and confounding. With subsequent application of criteria for novelty and biological plausibility, association with AMI remained for nine drugs ('prime suspects'): azithromycin; erythromycin; roxithromycin; metoclopramide; cisapride; domperidone; betamethasone; fluconazole; and megestrol acetate. LIMITATIONS Although global health status, co-morbidities, and time-invariant factors were adjusted for, residual confounding cannot be ruled out. CONCLUSION A strategy to identify potentially drug-induced AMI from electronic healthcare data has been proposed that takes into account not only statistical association, but also public health relevance, novelty, and biological plausibility. Although this strategy needs to be further evaluated using other healthcare data sources, the list of 'prime suspects' makes a good starting point for further clinical, laboratory, and epidemiologic investigation.
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21
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Prophylactic Postoperative Antibiotics for Enucleation and Evisceration. Ophthalmic Plast Reconstr Surg 2013; 29:281-5. [DOI: 10.1097/iop.0b013e3182916674] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Lee AR, Kim SJ, Kim J, Park JH, Lee JK, Kim JY, Lee SY, Kang HR. Successful desensitization for antitubercular drugs. ALLERGY ASTHMA & RESPIRATORY DISEASE 2013. [DOI: 10.4168/aard.2013.1.4.395] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Ae-Ra Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Jung Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Junghyun Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ju-Hee Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Kyu Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ju-Young Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Suh-Young Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
- Regional Pharmacovigilance Center, Seoul National University Hospital, Seoul, Korea
| | - Hye-Ryun Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
- Regional Pharmacovigilance Center, Seoul National University Hospital, Seoul, Korea
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23
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A randomized controlled trial comparing colonic irrigation and oral antibiotics administration versus 4% formalin application for treatment of hemorrhagic radiation proctitis. Dis Colon Rectum 2012; 55:1053-8. [PMID: 22965404 DOI: 10.1097/dcr.0b013e318265720a] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several treatments have been described for hemorrhagic radiation proctitis. The treatment outcomes are variable. Colonic irrigation and oral antibiotics for hemorrhagic radiation proctitis have been recently reported to be a novel and promising therapeutic approach. However, a comparative study of this treatment has never been investigated. OBJECTIVE This study aimed to compare colonic irrigation and oral antibiotics (irrigation group) versus 4% formalin application (formalin group) for treatment of hemorrhagic radiation proctitis. DESIGN This was a randomized controlled trial. SETTING This study was conducted in a tertiary care/university-based hospital. PATIENTS Fifty patients with hemorrhagic radiation proctitis were randomly assigned to each treatment group (n = 25). INTERVENTIONS For individuals allocated to the irrigation group, daily self-administered colonic irrigation with 1 L of tap water and a 1-week period of oral antibiotics (ciprofloxacin and metronidazole) were prescribed. For individuals allocated to the formalin group, 4% formalin application for 3 minutes was performed. MAIN OUTCOME MEASURES Patients' symptoms and the endoscopic findings of each group were collected. Patient satisfaction was surveyed. The outcomes were evaluated at 8 weeks after the initiation of treatment. RESULTS There was a significant improvement in rectal bleeding and bowel frequency in both treatment groups, but significant improvement in urgency, diarrhea, and tenesmus was demonstrated only in the irrigation group. The comparative study between 2 treatments revealed greater improvement in rectal bleeding, urgency, and diarrhea in the irrigation group. Twenty of 24 patients in the irrigation group and 10 of 23 patients in the formalin group were satisfied with the treatment. LIMITATIONS This trial cannot illustrate whether the antibiotics and the irrigation were equally important because of the limitation of a 2-armed design. CONCLUSIONS The treatment with colonic irrigation and oral antibiotics appears to be more effective than 4% formalin application for hemorrhagic radiation proctitis treatment and achieves higher patient satisfaction.
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Abstract
Drug-induced hypersensitivity syndrome is a systemic autoimmune disorder that results in mucocutaneous symptoms ranging in severity from mild pruritus to life-threatening skin and mucosal loss, with different nomenclature depending on the severity of the symptoms. The purpose of this article is to review the recent advances in understanding the pathology of drug-induced hypersensitivity syndrome, as well as current recommendations for both medical and wound management.
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Moss H, Collier JM, Collier S. 'An unusual response of dental sepsis to antibiotics: parallels with the Jarisch-Herxheimer reaction'. BMJ Case Rep 2012; 2012:bcr.07.2011.4500. [PMID: 22707695 DOI: 10.1136/bcr.07.2011.4500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Spreading odontogenic infections are a common source of hospital admissions to Oral and Maxillofacial Surgery (OMFS) units. This report describes an unusual reaction to routine treatment for a spreading odontogenic infection in a healthy male with no known allergies, requiring the patient to be managed supportively in the resuscitation room. The patient deteriorated rapidly after the administration of paracetamol, intravenous fluids, steroids and antibiotics, demonstrating delusional behaviour, fever, rigors, tachycardia and hypoxia. Fever associated with sepsis can lead to confusional states, but similar symptoms have been described in the literature as a reaction to antibiotic therapy known as Jarisch-Herxheimer (J-H) reaction. This is potentially the first time a J-H like reaction has been described in the context of dental sepsis. The authors feel that the OMFS team should be aware of possible sequelae of medical therapy in patients with acute dental sepsis and be confident in their management of these complications.
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Affiliation(s)
- Helen Moss
- CSCD Department, KCH NHS Foundation Trust, London, UK.
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26
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A suitable and efficient procedure for the removal of decontaminating antibiotics from tissue allografts. Cell Tissue Bank 2012; 14:107-15. [DOI: 10.1007/s10561-012-9305-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 02/29/2012] [Indexed: 10/28/2022]
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Nam YH, Jin HJ, Hwang EK, Shin YS, Ye YM, Park HS. Occupational rhinitis induced by capsaicin. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2011; 4:104-6. [PMID: 22379606 PMCID: PMC3283791 DOI: 10.4168/aair.2012.4.2.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 08/19/2011] [Accepted: 08/24/2011] [Indexed: 11/20/2022]
Abstract
Capsaicin is the spice component of red pepper. It can be easily inhaled, inducing a reproducible cough and provokes a secretory response from the human nasal mucosa. To date, there has been no report of occupational rhinitis (OR) caused by capsaicin. We report the case of a 44-year-old female mill worker who developed occupational rhinitis after 4 years of exposure to capsaicin. She developed nasal congestion, rhinorrhea, and itchy nose, which were all aggravated upon exposure at the workplace. The patient had negative responses to all common inhalant allergens, including capsaicin, by skin prick tests. The nasal provocation test with capsaicin showed that the nasal symptom score and eosinophil count increased 10 minutes after the provocation and decreased after 1 to 3 hours; no significant response was noted to house dust mite allergen. The patient's work-related rhinitis improved 1 month after she relocated and started pharmacological treatment. To our knowledge, this is the first case of OR caused by capsaicin exposure in the workplace. We provide evidence suggesting that OR may be mediated by a non-immunological mechanism.
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Affiliation(s)
- Young-Hee Nam
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
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28
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An SY, Hwang EK, Kim JH, Kim JE, Jin HJ, Jin SM, Kyun JO, Lee YH, Park HS, Choi YW, Lim SK, Ye YM. Vancomycin-associated spontaneous cutaneous adverse drug reactions. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2011; 3:194-8. [PMID: 21738885 PMCID: PMC3121061 DOI: 10.4168/aair.2011.3.3.194] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 03/25/2011] [Indexed: 11/30/2022]
Abstract
Purpose With the increase in vancomycin use, adverse drug reactions (ADRs) associated with vancomycin have been reported increasingly more often. However, the characteristics of cutaneous ADRs with and without systemic reactions (SRs) have not been described. This study investigated the characteristics of spontaneously reported and assessed ADRs associated with vancomycin by a pharmacovigilance center. Methods ADRs (n=121) associated with vancomycin in 96 patients were collected from 2008 to 2009. Records from physician- and nurse-reported suspected cases of vancomycin ADRs, ADR type, latent period, and laboratory results were compared between cutaneous ADRs with and without SRs. Results The main vancomycin-related ADRs were skin rashes (47.9%), hematologic abnormalities (17.36%), fever (12.4%), and elevated serum creatinine (12.4%). Significant differences were observed in latent period (days) and the mean change in eosinophils (%) between cutaneous (9.21±9.71 and 1.4±3.4, respectively) and other ADRs (14.03±11.71 and -0.5±3.5, respectively). Twelve cases of cutaneous ADRs with SRs had been initially reported as cutaneous ADRs only. Mean changes in the eosinophil count were significantly higher for cutaneous ADRs with SRs compared to those without SRs. Conclusions Skin rashes accompanied by peripheral eosinophilia, representing suspected immune-mediated delayed hypersensitivity reactions, are a common vancomycin ADR. For the early and exact detection of ADRs associated with vancomycin administration, close monitoring of laboratory tests, including complete blood counts with differential analysis, is recommended.
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Affiliation(s)
- So-Yeon An
- Ajou Regional Pharmacovigilance Center, Ajou University Hospital, Suwon, Korea
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Jeong HJ, Choi Y, Kim KY, Kim MH, Kim HM. C-kit binding properties of hesperidin (a major component of KMP6) as a potential anti-allergic agent. PLoS One 2011; 6:e19528. [PMID: 21559359 PMCID: PMC3085475 DOI: 10.1371/journal.pone.0019528] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 03/31/2011] [Indexed: 11/24/2022] Open
Abstract
Accumulation of mast cells can be causally related to several allergic inflammations. Stem cell factor (SCF) as a mast cell chemotaxin induces mast cell migration. To clarify a new effect of Pyeongwee-San extract (KMP6, a drug for indigestion) for the treatment of allergy, we investigated the effects of KMP6 on SCF-induced migration of rat peritoneal mast cells (RPMCs). A molecular docking simulation showed that hesperidin, a major component of KMP6, controls the SCF and c-kit binding by interaction with the active site of the c-kit. KMP6 and hesperidin significantly inhibited SCF-induced migration of RPMCs (P<0.05). The ability of the SCF to enhance morphological alteration and F-actin formation was also abolished by treatment with KMP6 or hesperidin. KMP6 and hesperidin inhibited SCF-induced p38 MAPK activation. In addition, SCF-induced inflammatory cytokine production was significantly inhibited by treatment with KMP6 or hesperidin (P<0.05). Our results show for the first time that KMP6 potently regulates SCF-induced migration, p38 MAPK activation and inflammatory cytokines production through hindrance of SCF and c-kit binding in RPMCs. Such modulation may have functional consequences during KMP6 treatment, especially mast cell-mediated allergic inflammation disorders.
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Affiliation(s)
- Hyun-Ja Jeong
- Biochip Research Center, Hoseo University, Asan, Republic of Korea
| | - Youngjin Choi
- Biochip Research Center, Hoseo University, Asan, Republic of Korea
| | - Kyu-Yeob Kim
- Department of Pharmacology, Kyung Hee University, Seoul, Republic of Korea
| | - Min-Ho Kim
- High-Enthalpy Plasma Research Center, Chonbuk National University, Jeonju, Republic of Korea
| | - Hyung-Min Kim
- Department of Pharmacology, Kyung Hee University, Seoul, Republic of Korea
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Thong BYH. Clinical applications of drug desensitization in the Asia-Pacific region. Asia Pac Allergy 2011; 1:2-11. [PMID: 22053290 PMCID: PMC3206230 DOI: 10.5415/apallergy.2011.1.1.2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Accepted: 04/09/2011] [Indexed: 12/24/2022] Open
Abstract
Drug desensitization is the induction, within hours to days, of a temporary state of tolerance to a drug which the patient has developed a hypersensitivity reaction to. It may be used for IgE and non-IgE mediated allergic reactions, and certain non-allergic reactions. The indication for desensitization is where no alternative medications are available for the treatment of that condition, and where the benefits of desensitization outweigh the risks. Desensitization is a therapeutic modality for drug allergy (similar to allergen specific immunotherapy for allergic rhinitis and insect venom anaphylaxis). In contrast, the drug provocation test is a diagnostic modality used to confirm or refute the diagnosis of drug allergy. This review discusses the clinical applications of desensitization for the treatment of common infectious, metabolic and cardiovascular diseases, and oncological conditions in the Asia-Pacific region.
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Affiliation(s)
- Bernard Yu-Hor Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433, Republic of Singapore
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Genetic and ethnic risk factors associated with drug hypersensitivity. Curr Opin Allergy Clin Immunol 2010; 10:280-90. [DOI: 10.1097/aci.0b013e32833b1eb3] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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