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Allopurinol hypersensitivity syndrome: hypersensitivity to oxypurinol but not allopurinol 总被引:2,自引:0,他引:2
Allopurinol is a xanthine oxidase inhibitor widely used to control plasma uric acid levels. Episodes of hypersensitivity to the drug are not rare. A severe form of this with a generalized exanthem, fever and liver involvement has been termed the allopurinol hypersensitivity syndrome (AHS). 1 , 2 Patch testing and lymphocyte stimulation testing (LST) are not helpful in confirming this sensitivity. Allopurinol works as a substrate of xanthine oxidase, and is rapidly oxidized into oxypurinol in vivo . Therefore, the biological half-life of oxypurinol is markedly longer than that of allopurinol. In addition, conspicuous pre-existing renal impairment has been noted in many AHS patients. Thus, it is possible that AHS is a manifestation of hypersensitivity to oxy-, not allopurinol. Here, we now report three cases of AHS in which there were significant lymphoproliferative reactions to oxypurinol but not allopurinol. 相似文献
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Müller PA Amann K Bröcker EB Trautmann A 《Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete》2012,63(3):223-225
Acute renal failure caused by interstitial nephritis as part of a drug hypersensitivity syndrome constitutes a rare, but potentially life-threatening adverse drug reaction. We describe a patient with a mild maculo-papular rash accompanied by eosinophilia after prolonged treatment with meropenem, vancomycin, and moxifloxacin. Subsequently, a rapidly progressing renal failure developed which dominated the clinical picture. Upon cessation of all suspected drugs and therapy with high-dose steroids for 6?weeks, the renal function slowly returned to normal. 相似文献
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Anticonvulsant hypersensitivity syndrome 总被引:5,自引:0,他引:5
Anticonvulsant hypersensitivity syndrome is an acute, life-threatening, idiosyncratic drug reaction seen with the aromatic antiepileptic drugs, phenytoin, carbamazepine, phenobarbital, and primidone, with frequent cross sensitivity. It usually occurs 2-8 weeks after initiation of therapy and the hallmark clinical features are fever, rash, and lymphadenopathy. Hematologic abnormalities such as eosinophilia, atypical lymphocytes, and internal organ involvement also occur with varying severity. A case of hypersensitivity syndrome due to carbamazepine with cross sensitivity to phenytoin is reported. It is emphasized that this serious drug reaction with diverse clinical presentations should be recognized and treated promptly. 相似文献
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药物超敏综合征又称伴嗜酸性粒细胞增多和系统症状的药疹,是通常使用某些药物后引起的一种严重的系统性药物反应.已有文献报道,药物超敏综合征缓解后,部分患者出现自身免疫性疾病,如Ⅰ型糖尿病、Graves病、桥本甲状腺炎、红斑狼疮、干燥综合征、白癜风、移植物抗宿主病等.但引起发病后的自身免疫病的发病机制尚未确定.目前,对于药物超敏综合征缓解后发生自身免疫病的发病机制与理论主要包括调节性T细胞的抑制功能缺陷、病毒感染、自身抗体的产生等.主要概述与药物超敏综合征相关的自身免疫性疾病以及发生自身免疫病的机制. 相似文献
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The drug hypersensitivity syndrome is a severe, multisystem reaction that typically develops within 2 months of starting a drug. We describe a case which has been unusually persistent, requiring prolonged treatment with systemic corticosteroids and after 1 year, ciclosporin. To the best of our knowledge, the use of ciclosporin for the treatment of the drug hypersensitivity syndrome has not been described previously. 相似文献
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Kaminsky A Moreno M Díaz M Charas V Bravo G Kien C 《International journal of dermatology》2005,44(7):594-598
Anticonvulsant hypersensitivity syndrome (AHS) is a rare and potentially fatal reaction characterized by the appearance of fever, skin rash and internal organ involvement.
Phenytoin, phenobarbital and carbamazepine are the most frequent aromatic anticonvulsants causing the reaction. This syndrome occurs 1–8 weeks after the initial drug exposure but, even though glucocorticoids appear to be useful in severe cases, discontinuation of the drug has been found to be essential in the resolution of symptoms. 相似文献
Phenytoin, phenobarbital and carbamazepine are the most frequent aromatic anticonvulsants causing the reaction. This syndrome occurs 1–8 weeks after the initial drug exposure but, even though glucocorticoids appear to be useful in severe cases, discontinuation of the drug has been found to be essential in the resolution of symptoms. 相似文献
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We report a 30-year-old female with hypersensitivity syndrome (HS) due to phenytoin. Her disease course was typical with elevation of the antibody titer for human herpes virus 6. Three courses of methylpredonisolone pulse therapy were required to control the disease activity. Since the pathogenic mechanism and treatments for HS have not been established, further clinical analyses are warranted. 相似文献
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A Antunes A Davril P Tréchot M Grandidier F Truchetet J F Cuny 《Annales de dermatologie et de vénéréologie》1999,126(6-7):518-521
BACKGROUND: Drug-induced hypersensitivity syndrome is an uncommon drug reaction typically manifested by severe skin lesions, fever, nodal enlargement, blood eosinophilia and hepatitis. CASE REPORT: A 16-year-old female patient with acne was treated with minocycline 100 mg/d for one month. She developed a hypersensitivity syndrome with a generalized pustulous eruption. Prick tests with minocycline diluted in vaseline were positive at 48 hours. DISCUSSION: This case of minocycline-induced hypersensitivity illustrates that prick tests performed late after the initial event can reproduce the initial lesions. The causal role of several drugs, particularly anticonvulsants, has been demonstrated in drug-induced hypersensitivity syndrome. Several recent publications have implicated minocycline. Although such cases are uncommon, it would appear that cyclines, particularly minocycline, are the main cause of conditions such as drug-induced hypersensitivity syndrome, acute systemic lupus erythematosus, pulmonary eosinophil infiltration, and pseudo-serum sickness. Such secondary effects must be recognized. Patients should be advised to discontinue treatment and consult if signs such as fever, node enlargement, joint pain, or skin reactions reappear. It may be useful to perform prick tests with minocycline 4 to 6 weeks after an initial eruption. 相似文献
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The anticonvulsant hypersensitivity syndrome 总被引:1,自引:0,他引:1
S.E. HANDFIELD-JONES R.E. JENKINS S.J. WHITTAKER C.P. BESSE D.H. MCGIBBON 《The British journal of dermatology》1993,129(2):175-177
Summary Anticonvulsants can cause a characteristic hypersensitivity reaction. This multisystem reaction typically presents as fever, mucocutaneous eruptions, lymphadenopathy and hepatitis. There is cross-reactivity between different anticonvulsants. which complicates subsequent therapy. We report three cases to illustrate both the typical features, and less common complications, of this under-recognized and life-threatening syndrome. 相似文献
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Fahim S Jain V Victor G Pierscianowski T 《Cutis; cutaneous medicine for the practitioner》2006,77(6):353-357
The drug hypersensitivity syndrome (DHS) is a rare but serious and potentially life-threatening reaction to common drugs in predisposed individuals. The syndrome is a triad of fever, skin eruption, and internal organ involvement. Prompt identification and discontinuation of the offending drug with symptomatic treatment of toxic effects is the mainstay of therapy for DHS. 相似文献
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The anticonvulsant hypersensitivity syndrome 总被引:1,自引:0,他引:1
M Baba M Karaka VL Aksungur S Homan A Yücel MA Acar HR Memolu 《Journal of the European Academy of Dermatology and Venereology》2003,17(4):399-401
BACKGROUND: The anticonvulsant hypersensitivity syndrome is a potentially fatal multisystemic reaction to anticonvulsant medications. OBJECTIVES: The purpose of this study was to investigate the clinical characteristics of anticonvulsant hypersensitivity syndrome. RESULTS: A total 32 subjects, aged from 6 to 72 years, diagnosed as having anticonvulsant hypersensitivity syndrome based on clinical and histopathological findings, were included in the study. In 22 of the 32 cases, the anticonvulsants had been administered prophylactically after craniotomy and in 10 cases for epilepsy. When the cases were assessed for skin lesions, maculopapular eruption was registered in 22, Stevens-Johnson syndrome in five, and toxic epidermal necrolysis (TEN) in five. Treatment included suspension of the offending drug and then, except for the cases with toxic epidermal necrolysis, administration of corticosteroids. The 22 cases that required anticonvulsant therapy were treated with valproic acid. In all cases, we observed rapid clinical improvement corroborated by laboratory findings. CONCLUSIONS: It is essential that due importance be given to the development of an eruption in individuals to whom anticonvulsants are administered after craniotomy because anticonvulsant hypersensitivity syndrome is likely to be life-threatening. 相似文献