Drug-induced hypersensitivity syndrome due to phenytoin: Case report and review of the literature DOI Creative Commons
Lingling Wang, Jie Zhang, Xichun Wang

и другие.

Medicine, Год журнала: 2024, Номер 103(39), С. e39715 - e39715

Опубликована: Сен. 27, 2024

Rationale: Drug hypersensitivity syndrome (DIHS) is a rare but potentially fatal adverse drug reaction characterized by fever, rash, and visceral organ damage, particularly affecting the liver. Early recognition appropriate management are crucial to prevent serious complications. However, there limited information on clinical presentation of DIHS, especially in context antiepileptic drugs. This case report aims highlight importance recognizing subtle signs symptoms which can be easily overlooked, use. Patient concerns: We 15-year-old male patient who developed DIHS after being prescribed phenytoin sodium for epilepsy. The presented with sore throat, jaundice, liver dysfunction. Initially, did not receive glucocorticoids experienced additional reactions cefoxitin phosphatidylcholine, likely due cross-reactivity. Diagnoses: diagnosis was made based patient’s presentation, including extensive involvement, hematological abnormalities. temporal association use sodium, along exclusion other causes fever supported diagnosis. Interventions: Upon initiation glucocorticoid therapy dexamethasone, significantly improved. rash pruritus decreased, laboratory values showed improvement, decrease enzymes normalization white blood cell counts. Outcomes: resolved within 48 hours starting corticosteroids, no evidence ongoing inflammation as indicated C-reactive protein levels. Furthermore, 30-month follow-up revealed recurrence dysfunction, or organic indicating long-term effectiveness treatment administered. Lessons: highlights It underscores potential benefits early managing DIHS. also serves reminder cross-reactivity need cautious selection during acute phase syndrome.

Язык: Английский

Severe cutaneous adverse reactions DOI
Wen‐Hung Chung, Maja Mockenhaupt, Kimberly G. Blumenthal

и другие.

Nature Reviews Disease Primers, Год журнала: 2024, Номер 10(1)

Опубликована: Апрель 25, 2024

Язык: Английский

Процитировано

20
Self-assembling Bletilla polysaccharide nanogels facilitate healing of acute and infected wounds via inflammation control and antibacterial activity DOI

De-Jin Ma,

Tianhua Li,

Shuo Yang

и другие.

International Journal of Biological Macromolecules, Год журнала: 2025, Номер 299, С. 140125 - 140125

Опубликована: Янв. 20, 2025

Язык: Английский

Процитировано

1
Drug‐Induced Hypersensitivity Syndrome/Drug Reaction With Eosinophilia and Systemic Symptoms With Reactivation of Human Herpesvirus‐6 in a Liver Transplant Recipient DOI Open Access
Rebecca Unterborn, Kaitlin Blotske,

Maheen Z. Abidi

и другие.

Transplant Infectious Disease, Год журнала: 2025, Номер unknown

Опубликована: Янв. 30, 2025

To the Editor, Drug-induced hypersensitivity syndrome (DIHS) or drug reaction with eosinophilia and systemic symptoms (DRESS) is defined by rash, fever, internal organ involvement, manifestations after prolonged exposure to an inciting medication [1, 2]. It distinct from other reactions as it can involve viral reactivation, most commonly reported human herpesvirus (HHV)-6,7 [3]. The interaction between herpes viruses DIHS/DRESS thought be mediated a complex interplay immune system, specifically T lymphocytes [2, 4]. CD4 cells are initiate allergies when exposed antigen CD8 may target destroy virally infected cells, though much still unknown about pathogenesis of [4]. has been described in transplant patients. incidence United States one 1000 10,000, patients who immunosuppressed at higher risk developing due reduced function their for reactivation [1]. Antibiotics account around 25% cases A 63-year-old female history end-stage liver disease secondary primary sclerosing cholangitis (PSC), underwent living donor 2000 redo deceased October 2024 recurrent PSC. Induction immunosuppression included high-dose intravenous (IV) methylprednisolone mg once steroid taper followed maintenance tacrolimus, mycophenolate, prednisone. She was also prescribed acyclovir 1 month (Cytomegalovirus [CMV] recipient negative) trimethoprim-sulfamethoxazole (TMP-SMX) 6 months post-transplant per protocol. Approximately 1-month post-redo transplant, patient presented 3 days whole-body rash associated facial tongue swelling. provided having course levofloxacin upper respiratory tract possible sinus infection approximately 2 prior intense diffuse itching, skin erythema, lip/tongue swelling, lymphadenopathy, fevers. See Figures visual representation oral findings rash. Her labs were notable acute kidney injury creatinine 1.6 mg/dL (baseline mg/dL), normal tests, baseline mild anemia hemoglobin 9–10 g/dL, absolute 2.9×109/L, elevated inflammatory markers (C-reactive protein 31.4 mg/L sedimentation rate 53 mm/h). TMP-SMX promptly discontinued concern DIHS/DRESS, she started on doses prednisone requested dermatology. CMV Epstein–Barr Virus whole blood quantitative polymerase chain (PCR) 0 HHV-6 PCR 1030 copies/mL. Mycophenolate half original dose setting active infection. Repeat following day 2565 IV ganciclovir empiric treatment low-grade viremia DIHS/DRESS. week later, repeat 5750 copies/mL, which felt within margin error test assay, so antiviral not adjusted. then received two immunoglobulins (IVIG) addition steroids Following clinical improvement receipt 8 days, transitioned induction-dose valganciclovir. undetectable later discharged home good condition. This case highlights No serologic testing either recipient. often presents 2–6 weeks but occur more quickly re-exposure [5]. onset symptoms, creating bimodal natural that worse start worsening There no data how recipients affect this timeline. Antibiotic-related estimated 9.06% sulfonamide 1.96% fluoroquinolone 45%–60% [6-8]. However, mechanism prevalence related specific DIHS/DRESS-causing agents well defined. Typical management includes cessation offending agent, use topical and/or corticosteroids, adjunct symptomatic therapies [5, 9]. Challenges regarding corticosteroids include amplification load viral-related manifestations. Risk reduction elevations mitigated through utilization recommended severe dysfunction present Further complications exist immunosuppressive therapies. Additional considerations IVIG therapy given life-threatening signs limited reports mixed responses various safety concerns 9, 10]. Currently, there approved antivirals market HHV-6, nor randomized controlled trials assessing efficacy [11]. Support based vitro studies evidence inhibition ganciclovir, valganciclovir, foscarnet, cidofovir, brincidofovir. Higher activity demonstrated cidofovir however tolerability adverse effects limit use. Initiation encephalitis considered moderate disease. Reduction well-described separately, few develop emphasizes need prompt

Язык: Английский

Процитировано

1
DRESS syndrome following dalbavancin and oritavancin administration in a patient with osteomyelitis DOI Creative Commons

Jina Bai,

Emily Frech Preciado,

Mary Baxter Harlow

и другие.

Case Reports in Dermatology, Год журнала: 2025, Номер unknown, С. 1 - 10

Опубликована: Март 28, 2025

Dalbavancin and oritavancin are newer long-acting antibiotics with potent activity against gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA). To our knowledge, there have been no reported cases of drug reaction eosinophilia systemic symptoms (DRESS) syndrome in a patient treated dalbavancin oritavancin. A woman her 20s presented right thumb abscess cellulitis that failed to respond several courses oral antibiotics, resulting recurrent emergency room visits over 3 weeks. Approximately 1 month after the initial skin infection, magnetic resonance imaging revealed osteomyelitis thumb. She was single dose followed by two weekly doses dalbavancin, which successfully resolved infection. However, she subsequently developed fever rash consistent DRESS syndrome, likely triggered or dalbavancin. Given prolonged half-life these medications, required treatment high-dose steroids for an extended duration. second-generation lipoglycopeptide provide coverage MRSA. They approved acute bacterial structure infections used off-label bacteremia, endocarditis, osteomyelitis. Their half-lives - 257 h 195 allow less frequent dosing. long also leads exposure event adverse effects. Here, we report first case

Язык: Английский

Процитировано

1
Rare delayed hypersensitivity reactions to contrast media: Severe cutaneous adverse reactions DOI Creative Commons
Aart J. van der Molen, Annick A. J. M. van de Ven, Francisco Vega

и другие.

European Journal of Radiology, Год журнала: 2024, Номер 183, С. 111908 - 111908

Опубликована: Дек. 31, 2024

Язык: Английский

Процитировано

3
Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome Associated With Celecoxib: A Case Report of a Rare Entity DOI Open Access
Maria Adriana Henriques, Mariana Guerra, Isabel Correia

и другие.

Cureus, Год журнала: 2025, Номер unknown

Опубликована: Янв. 3, 2025

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity characterized by widespread skin rash, multi-system involvement, often eosinophilia. While anticonvulsants, allopurinol, antibiotics are the most implicated agents, non-steroidal anti-inflammatory drugs (NSAIDs) such as celecoxib can be triggers in rare cases. We report case of 63-year-old female presenting 10-day history jaundice, nausea, right upper quadrant pain following repeated use celecoxib. Initially diagnosed acute hepatitis unknown origin, she subsequently developed fever, respiratory failure, pancytopenia, maculopapular rash 20th day hospitalization. The clinical diagnosis DRESS was confirmed through biopsy. Systemic corticosteroid therapy (methylprednisolone 0.5 mg/kg/day) led to progressive resolution symptoms, leading hospital discharge on 28. This highlights diagnostic challenges syndrome, particularly absence

Язык: Английский

Процитировано

0
Diagnosis and Management of Skin Toxicities in Systemic Treatment of Genitourinary Cancers DOI Open Access

Deepro Chowdhury,

Laura D Chin,

Roupen Odabashian

и другие.

Cancers, Год журнала: 2025, Номер 17(2), С. 251 - 251

Опубликована: Янв. 14, 2025

The landscape of available therapeutic options for treatment genitourinary (GU) cancers is expanding dramatically. Many these treatments have distinct, sometimes severe, skin toxicities including morbilliform, bullous, pustular, lichenoid, eczematous, psoriasiform, and palmoplantar eruptions. Pruritus pigmentation changes also been noted. This review aims to synthesize dermatologic events observed with antibody drug conjugates, poly (ADP-ribose) polymerase (PARP) inhibitors, androgen receptor pathway tyrosine kinase immune checkpoint the combination agents used GU cancers. It provides a guide on diagnosis initial management rashes medical oncologists.

Язык: Английский

Процитировано

0
Carbon dots derived from organic drug molecules with improved therapeutic effects and new functions DOI
Zhaofan Wu, Xiao-Xiao Luo, Xiaofeng Shi

и другие.

Nanoscale, Год журнала: 2025, Номер unknown

Опубликована: Янв. 1, 2025

This article reviews the functions of drug-derived CDs compared with their precursors and demonstrates broad application prospects in biomedicine.

Язык: Английский

Процитировано

0
Morbilliform Eruptions: Differentiating Low-Risk Drug Eruptions, Severe Cutaneous Adverse Reactions, Viral Eruptions, and Acute Graft-Versus-Host Disease DOI Creative Commons
Allison Yan, Lauren M. Madigan,

Abraham M. Korman

и другие.

American Journal of Clinical Dermatology, Год журнала: 2025, Номер unknown

Опубликована: Янв. 31, 2025

Morbilliform eruptions, which are a clinical reaction pattern characterized by erythematous macules and papules coalescing into patches that cover most of the skin surface, one common cutaneous findings in inpatient setting. In hospital setting, causes benign due to low-risk drug exanthems; however, morbilliform eruptions may also be sign high-risk diseases, including Stevens-Johnson syndrome/toxic epidermal necrolysis, with eosinophilia systemic symptoms/drug-induced hypersensitivity syndrome, acute generalized exanthematous pustulosis, graft-versus-host disease. Proper identification etiology risk stratification eruption is critical ensure proper management optimize patient outcomes. this review, we discuss key features differentiate from as well specific characteristics different eruptions. Additionally, offer algorithm applied who presents rash.

Язык: Английский

Процитировано

0
Infectious Disease Detective: A Case of a Mysterious Rash DOI Open Access

Lawrence DeLorenzo,

Danielle C Thor, Cindy Hou

и другие.

Cureus, Год журнала: 2025, Номер unknown

Опубликована: Март 22, 2025

Drug reactions are often serious and complex events that can greatly affect patient outcomes. Many of these drug manifest dermatologically by altering the skin's structure or function most typically eosinophilic mediated. Fortunately, few result in severe consequences for patients, even fewer fatal. However, spectrum what constitutes a reaction is expansive with consistent potential novel findings. In case presented, an 81-year-old male was found to have whole-body perivascular dermatitis eosinophils eventually determined be secondary delayed reaction. Through this report, importance detailed investigation amplified context rashes unknown origin beyond.

Язык: Английский

Процитировано

0