Assuntos
Síndrome de Hipersensibilidade a Medicamentos , Eosinofilia , Exantema , Humanos , Temozolomida/efeitos adversos , Síndrome de Hipersensibilidade a Medicamentos/diagnóstico , Síndrome de Hipersensibilidade a Medicamentos/etiologia , Exantema/induzido quimicamente , Eosinofilia/induzido quimicamente , Eosinofilia/diagnósticoAssuntos
Eosinofilia/induzido quimicamente , Fasciite/induzido quimicamente , Fatores Imunológicos/efeitos adversos , Natalizumab/efeitos adversos , Eosinofilia/diagnóstico por imagem , Eosinofilia/patologia , Fasciite/diagnóstico por imagem , Fasciite/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/tratamento farmacológico , UltrassonografiaRESUMO
Dapsone hypersensitivity syndrome (DHS) can be classified as a 'drug reaction with eosinophilia and systemic symptoms' (DRESS). It has a variable course, it is not dose dependent and may present with different clinical and laboratory abnormalities. In some cases it may be fatal. We describe a 31 year old man with lepromatous leprosy in whom DHS developed 4 weeks after initiation of World Health Organization multibacillary multidrug therapy (dapsone, clofazimine and rifampin). He had fever, dehydration, diffuse rash, pain on abdominal palpation and inguinal painless lymph nodes. Severe anaemia, abnormal liver function and hyperbilirubinaemia were also found. The patient was treated with prednisone 50 mg daily. There was gradual improvement in the clinical and laboratory signs. We encourage health professionals to be aware of the risk of DHS and to have in mind the development of investigative studies related to HLA and MHC in these patients.
Assuntos
Dapsona/efeitos adversos , Dapsona/uso terapêutico , Hipersensibilidade a Drogas , Hansenostáticos/efeitos adversos , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/tratamento farmacológico , Adulto , Dapsona/administração & dosagem , Eosinofilia/induzido quimicamente , Humanos , Hansenostáticos/administração & dosagem , MasculinoAssuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Artrite Psoriásica/tratamento farmacológico , Eosinofilia/induzido quimicamente , Imunoglobulina G/efeitos adversos , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adalimumab , Antirreumáticos/efeitos adversos , Etanercepte , Humanos , Masculino , Pessoa de Meia-Idade , Receptores do Fator de Necrose Tumoral , Índice de Gravidade de DoençaRESUMO
Carbamazepine is widely used in the treatment of epilepsy, neuralgic pain, and bipolar affective disorders. Several adverse drug reactions have been described during the course of carbamazepine administration, including exanthemata and hematological reactions. Carbamazepine is one of the common drugs that have been implicated in the etiology of drug hypersensitivity syndrome. A 50-year-old male presented with generalized erythroderma following 10 weeks of ingestion of carbamazepine 200 mg daily for idiopathic epilepsy. His systemic examination was within normal limits. Blood counts revealed marked eosinophilia of 52% (absolute eosinophil count of 10,400 per mm3). Bone marrow aspiration revealed a moderate increase in the eosinophilic series with cells showing normal morphology. The eosinophil counts returned to normal after 2 weeks of oral prednisolone therapy. This case is reported because of its rarity in the Indian medical literature.