• Title/Summary/Keyword: Drug hypersensitivity

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A Case of Drug Rash with Eosinophilia and Systemic Symptoms Associated with Valproic Acid and Olanzapine Treatment in Patient with Bipolar Disorder (양극성장애에 대한 Valproic Acid와 Olanzapine 치료 중 발생한 호산구증가증과 전신증상을 동반한 약물발진(DRESS) 증후군 1예)

  • Lee, Ung;Lim, Se-Won
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.162-166
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    • 2017
  • Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, medication-induced hypersensitivity reaction with long latency. It is characterized by fever, rash, leukocytosis with eosinophilia, atypical lymphocytosis, and internal organ involvement. The most common causes of DRESS syndrome are sulfonamides and anticonvulsants such as carbamazepine and lamotrigine. However, valproic acid and olanzapine could develop DRESS syndrome. We report a case of DRESS syndrome associated with valproic acid and olanzapine in a 41 years old male patient with bipolar disorder.

A case of antiepileptic drug hypersensitivity syndrome by lamotrigine mimicking infectious mononucleosis and atypical Kawasaki disease (전염성 단핵구증과 비전형적 가와사키병과 유사한 lamotrigine에 의한 항경련제 과민증후군 1예)

  • Yoo, Su Jung;Park, Ihl Sung;Suh, Eun Sook
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.389-391
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    • 2009
  • Antiepileptic drug hypersensitivity syndrome (AHS), a delayed immunological reaction, is a relatively rare side effect of antiepileptic drugs and is usually overlooked. An array of symptoms can occur one to eight weeks after treatment with an antiepileptic drug. Symptoms may be as simple as a fever, skin rash, or lymphadenopathy, but may eventually involve internal organs and cause fatal outcomes. Additionally, because the symptoms resemble the features of various arrays of diseases and the reported mortality rate is approximately 10%, the importance of early diagnosis and ability to differentiate AHS from other diseases cannot be overemphasized. We report a case of a 14-year-old girl with AHS caused by lamotrigine, which mimicked atypical Kawasaki disease and infectious mononucleosis.

A Case of Anticonvulsant Hypersensitivity Syndrome with Subcarinal Lymph node Enlargement and Eosinophilic Pneumonia Induced by Carbamazepine (Carbamazepine에 의한 기관분기부하 림푸절 종대와 호산구성 폐렴이 동반된 Anticonvulsant Hypersensitivity Syndrome 1예)

  • Jeon, Ik Soo;Jang, Jae Young;Park, Jee Eun;Song, Chun Young;Jung, Chang Wook;Kim, Sung Hun;Kang, Kyung Woo
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.55-60
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    • 2004
  • Anticonvulsant hypersensitivity syndrome (AHS) is an uncommon, but potentially fatal and mutilsystemic disorder that occurs after exposure to the arene oxide-producing anticonvulsants-carbamzepine, phenobarbital and phenytoin. The multisystemic reactions include fever, skin eruptions, lymphadenopathy, hematologic abnormality and hepatitis. The diagnosis of AHS is made by history of drug exposure and clinical course. No specific treatments are proved as benefit except discontinuing the offending drug and trying the steroids in some severe cases. We report a case of carbamazepine induced anticonvulsant hypersensitivity syndrome characterized by skin rash, eosinophilia, subcarinal lymphadenopathy and eosinophilic pneumonia. The patient was resolved completely after only discontinuing carbamazepine.

Adverse Event Study on Ojeok-san Extract Powders RCT in Low Back Pain Patients (요통환자 대상 오적산 엑스산 투여 임상시험 이상반응 연구)

  • Yoon, Eun-Hye;Jang, Min-Gee;Hwang, Ji-Hoo;Lee, Seung-Hoon;Jeong, Won-Je;Lee, Jae-Dong;Lee, Seung-Deok;Kim, Kyung-Ho;Kim, Kap-Sung;Kim, Eun-Jung
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.195-202
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    • 2010
  • Objectives : This study was performed to report adverse events in Ojeok-san extract powders RCT. Methods : 180 patients with LBP were randomized into groups for a double blind, placebo-controlled clinical study. They received Ojeok-san simple Extract, Ojeok-san complex Extract or placebo in powders, orally dissolved 3times a day for 4weeks. During 4weeks, we researched the symptoms and duration of adverse events and Digest ability, Milk hypersensitivity, Starch hypersensitivity, Caramel hypersensitivity, West-med hypersensitivity, Herb-med hypersensitivity in patients who had adverse events. Results : 52patients(28.9%) had adverse events and of them 44patients(28.9%) had lost adverse events naturally. But 5patients(2.8%) were withdrawn from the research because of the adverse events. Most of the symptoms of adverse event was Gastrointestinal symptom(88.3%) and adverse events frequency was not different from Ojeok-san simple Extract, Ojeok-san complex Extract and placebo. Conclusions : Ojeok-san extract powders had adverse events no different from the placebo, which shows that it is a safe drug.

Effects of Swainsonine on the Cell-mediated Immune Responses of Lipopolysaccharide (리포포리사카라이드의 세포성 면역반응에 미치는 스와인소닌의 영향)

  • Chae, Byeong-Suk;Ahn, Young-Keun;Kim, Joung-Hoon
    • YAKHAK HOEJI
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    • v.42 no.1
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    • pp.75-81
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    • 1998
  • Effects of swainsonine (SW: 8${\alpha}$, ${\beta}$-indolizidine-1alpha, 2${\alpha}$, 8${\beta}$-triol from Locoweed) on the cellular and nonspecific immune responses of lipopolysaccharide (LPS) wer e studied in ICR mice. Mice were divided into 4 groups (10mice/group), and LPS was given to each mouse 1 hr after i.p. injection with 3.7mg/kg of SW by i.p. injection twice a week for 14 days at a dose of 2mg/kg. Immune responses of the delayed-type hypersensitivity response (DTH) to sheep red blood cells (s-RBC), phagocytic activity and natural killer (NK) cell activity were evaluated. LPS treatment didn`t affect NK cell activity, phagocytic activity, DTH to s-RBC compared with those in controls, and phagocytic activity of sareoma 180 tumor bearing mice. However, circulating leukocytes were significantly decreased. Combinaton of LPS and SW increased circulating leukocytes significantly compared vath that in LPS alone, and DTH to s-RBC, NK cell activity and phagocytic activities of normal and sarcoma tumor bearing mice were not affected. These findings indicate that SW didn`t affected the cellular immune responses suppressed by LPS but significantly increased circulating leukocytes.

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Effects of Okbyungpoongsan Administration on Innate and Specific Immune Response in the Mouse (옥병풍산(玉屛風散)이 생쥐의 선천성 및 특이적 면역반응에 미치는 영향)

  • Song, Bong-Keun;Jeon, Yong-Cheol
    • The Journal of Korean Medicine
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    • v.20 no.2
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    • pp.177-186
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    • 1999
  • Okbyungpoongsan(OBPS) has long been known to have anti-allergic effect. In order to evaluate the influence on innate and specific immune response, the effects of OBPS on vascular permeability. hypersensitivities and phagocytic functions were measured. As the results, OBPS increased phagocytic activity of peritoneal macrophages in vitro and in vivo. But OBPS depressed formation of reactive oxygen intermediates(ROI) in vitro and in vivo, while the drug enhanced generation macrophages. Foot pad swelling in the mouse and contact hypersensitivity against dinitroflouorobenzene were decreased. OBPS had no effect on NK cells. But OBPS decreased vascular permeability induced by histamine without statistical significance. These results demonstrate that OBPS suppresses hypersensitivity reactions without affecting phagocytic functions and formation of ROI from macrophages. It also means that OBPS acts as a effective inducer to synthesis of nitric oxide which is effective for the infectious disease while it does damage to tissue less as it suppresses ROI, So we can conclude that OBPS could be used for the treatment of the disease related with immune function.

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Clinical Features of Oxaliplatin Induced Hypersensitivity Reactions and Therapeutic Approaches

  • Bano, Nusrat;Najam, Rahila;Qazi, Faaiza;Mateen, Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1637-1641
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    • 2016
  • Oxaliplatin, a third generation novel platinum compound is the most effective first line chemotherapeutic agent for colorectal cancer (CRC) in combination with 5FU and leucovorin. It is indicated for pancreatic, gastric and testicular cancers combined with bevacuzimab, capecitabine, irinotecan and other cytotoxic agents. However, moderate to severe hypersensitivity reactions (HSR) during or after oxaliplatin infusion usually require cessation of chemotherapy or substitution of the key therapeutic drug which largely interferes with improved patient prognosis. This mini- review showcases recent and accepted opinions/approaches in oxaliplatin induced HSR management. Physicians and oncologists have varying attitudes regarding the decision to rechallenge the patient after an HSR experience, efficacy of desensitization protocols, effectiveness and selection of drugs for premedication and possibilities of cross sensitivity to other platinum agents (e.g. carboplatin). A brief insight into underlying molecular mechanisms and clinical manifestations of oxaliplatin induced HSR is offered. We have also discussed the management of oxaliplatin induced HSR and risk stratification for a successful and complete chemotherapeutic plan.

A Study on the Side Effect of Crude Drugs (상용 한약재의 부작용에 관한 연구)

  • Ahn, Dug-Kyun;Kim, Chan-Soo
    • Korean Journal of Pharmacognosy
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    • v.14 no.3
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    • pp.102-106
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    • 1983
  • As many crude drugs are used in the oriental medical field problems on the side effects of these drugs come to the front. To conduct delayed-type hypersensitivity we selected 29 kinds of drugs used frequently for therapeutic agents in oriental medical hospitals (Table I). The cell-mediated immune response was evaluated by measuring the foot pad swelling reaction and humoral immune response by measuring the antibody formation to these crude drugs. Mice were given these drugs intraperioneally for sensitization and challenged with same drug as used for sensitization respectively by intral dermal injection on the left and righ hind foot pad 4 days after senstization and then the foot pads were measured with the dial micrometer. The results were as follow; 1) Gentianae Scabrae Radix, Arecae Semen, Corydalis Tuber, and Paeoniae Radix were significant as delayed-type hypersensitivity inducers. 2) None of the crude drugs tested had effect on the induction of humoral immune response.

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Effects of Epimedii Herba Fraction on Response in ICR Mice (음양곽분획물이 생쥐의 면역반응에 미치는 영향)

  • Kim, Joung-Hoon;Kim, In-Hoon;Chae, Byeong-Suk;Kang, Tae-Wook;Park, Chan-Bong;Ahn, Young-Keun
    • YAKHAK HOEJI
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    • v.40 no.2
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    • pp.230-237
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    • 1996
  • The fractions of Epimedii Herba were examined for the immunological effects in ICR mice. Mice were divided into 4 groups and administered orally the fractions of Epimedii Herba for 10 days. The results of this study were summarized as following: (1) The fraction 1 (EtOAc layer) administered group as compared with control group significantly decreased spleen weight, Arthus reaction and hemagglutination (HA) titer but significantly increased circulating white blood cells (WBC). (2) The fraction 2 ($H_20$ layer) administered group as compared with control group significantly decreased liver weight, Arthus reaction and HA titer but significantly increased WBC. (3) The fraction 3 (ppt) administered group as compared with control group significantly increased liver weight, thymus weight rate, delayed type hypersensitivity, phagocytic activity and WBC. The results showed that Frs. 1 and 2 administered groups reduced humoral immune response but increased WBC, and that Fr. 3 administered group increased cell-mediated immune response, phagocytic activity and WBC.

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DRESS syndrome with acute interstitial nephritis caused by quinolone and non-steroidal anti-inflammatory drugs (퀴놀론과 비스테로이드소염제 투여 후 발생한 급성 간질성 신염이 동반된 DRESS 증후군)

  • Kim, Soo Jin;Nam, Young-Hee;Juong, Ji Young;Kim, Eun Young;Lee, Su Mi;Son, Young Ki;Nam, Hee-Joo;Kim, Ki-Ho;Lee, Soo-Keol
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.59-63
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    • 2016
  • Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.