scholarly journals Acute Low-Dose Hydralazine-Induced Lupus Pneumonitis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Sarah K. Holman ◽  
Donique Parris ◽  
Sarah Meyers ◽  
Jason Ramirez
Keyword(s):  
Low Dose ◽  
Inflammatory Cells ◽  
Chest Ct ◽  
Prolonged Treatment ◽  
Drug Induced ◽  
Asthma Exacerbations ◽  
High Doses ◽  
Diagnostic Work ◽  
Work Up ◽  
Restrictive Pattern

A 35-year-old female was started on hydralazine 10 mg orally three times a day for treatment of postpartum hypertension. Three months later, after multiple unsuccessful courses of prednisone and antibiotics for presumed pneumonia and asthma exacerbations, her respiratory symptoms progressed in severity and she developed resting hypoxia. Previous diagnostic work-up included spirometry with a restrictive pattern, chest CT showing bilateral basilar consolidation, negative BAL, and nonspecific findings on lung biopsy of mild inflammatory cells. Review of systems was positive for arthralgia, lymphadenopathy, paresthesia, and fatigue that began four weeks after starting hydralazine. A clinical diagnosis of hydralazine-induced lupus (HIL) with pneumonitis was made. Antihistone antibodies were positive supporting a diagnosis of HIL. Management included cessation of hydralazine and a prolonged steroid taper. Within days, patient began improving symptomatically. Six weeks later, CT chest showed complete resolution of infiltrates. Genetic testing revealed she was heterozygous for N-acetyltransferase 2 (intermediate acetylator). Drug-induced lupus should be considered in patients with lupus-like symptoms taking medications with a known association. While the majority of HIL cases occur with high doses and prolonged treatment, cases of low-dose HIL have been reported in patients who are slow acetylators.

scholarly journals Suspected phenobarbital-induced fever in a cat

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691983021
Author(s):  
Dylan M Djani ◽  
William E Draper
Keyword(s):  
Fever Of Unknown Origin ◽  
Clinical Signs ◽  
Unknown Origin ◽  
Drug Induced ◽  
Fluid Analysis ◽  
Diagnostic Work ◽  
Phenobarbital Administration ◽  
Work Up ◽  
The Brain ◽  
Diagnostic Work Up

Case summary A 3-year-old spayed female domestic shorthair cat developed a fever 1 week after starting the anticonvulsant phenobarbital. A diagnostic work-up for seizures and subsequent onset of fever of unknown origin, consisting of MRI of the brain, cerebrospinal fluid analysis and infectious disease testing, was unremarkable. The cat was switched from phenobarbital onto pregabalin with complete resolution of the fever within 24 h, consistent with a drug-induced fever following phenobarbital administration. Relevance and novel information While anticonvulsant hypersensitivities have been reported and studied in veterinary medicine, phenobarbital-induced fever outside of the context of systemic clinical signs has not been documented in the veterinary scientific literature. Drug-induced fever secondary to anticonvulsants should be considered in patients that develop a fever after starting anticonvulsant therapy with an unrewarding diagnostic work-up for fever of unknown origin.

scholarly journals Non-steroidal anti-inflammatory drug-induced diaphragm disease: an uncommon cause of small bowel obstruction

2016 ◽  
Vol 98 (8) ◽  
pp. e189-e191 ◽  
Author(s):  
MME Coolsen ◽  
SJ Leedham ◽  
RJ Guy
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Small Bowel Resection ◽  
Drug Induced ◽  
Inflammatory Drug ◽  
Diaphragm Disease ◽  
Anti Inflammatory ◽  
Diagnostic Work ◽  
Work Up

Surgeons frequently deal with small bowel obstruction. However, small bowel obstruction caused by non-steroidal anti-inflammatory drug (NSAID)-induced diaphragm disease is very rare. The diagnosis is challenging, as symptoms are often non-specific and radiological studies remain inconclusive. We present a case of a 63-year-old man who, after an extensive diagnostic work-up and small bowel resection for obstructive symptoms, was finally diagnosed with NSAID-induced diaphragm disease as confirmed by histology. An unusual aspect of this case is that the patient stopped using NSAIDs after he was diagnosed with a gastric ulcer 2–years previously. This suggests that NSAID-induced diaphragms of the small bowel take some time to develop and underlines the importance of careful history taking.

scholarly journals Prophylactic neuroprotection against stroke: Low-dose, prolonged treatment with deferoxamine or deferasirox establishes prolonged neuroprotection independent of HIF-1 function

2011 ◽  
Vol 31 (6) ◽  
pp. 1412-1423 ◽  
Author(s):  
Yanxin Zhao ◽  
David A Rempe
Keyword(s):  
High Risk ◽  
Stroke Volume ◽  
Low Dose ◽  
Chronic Administration ◽  
Iron Chelator ◽  
Prolonged Treatment ◽  
Clinical Use ◽  
High Doses ◽  
Dependent Mechanism

Prophylactic neuroprotection against stroke could reduce stroke burden in thousands of patients at high risk of stroke, including those with recent transient ischemic attacks (TIAs). Prolyl hydroxylase inhibitors (PHIs), such as deferoxamine (DFO), reduce stroke volume when administered at high doses in the peristroke period, which is largely mediated by the hypoxia-inducible transcription factor (HIF-1). Yet, in vitro experiments suggest that PHIs may also induce neuroprotection independent of HIF-1. In this study, we examine chronic, prophylactic, low-dose treatment with DFO, or another iron chelator deferasirox (DFR), to determine whether they are neuroprotective with this paradigm and mediate their effects through a HIF-1-dependent mechanism. In fact, prophylactic administration of low-dose DFO or DFR significantly reduces stroke volume. Surprisingly, DFO remained neuroprotective in mice haploinsufficient for HIF-1 (HIF-1 +/ –) and transgenic mice with conditional loss of HIF-1 function in neurons and astrocytes. Similarly, DFR was neuroprotective in HIF-1 +/ mice. Neither DFO nor DFR induced expression of HIF-1 targets. Thus, low-dose chronic administration of DFO or DFR induced a prolonged neuroprotective state independent of HIF-1 function. As DFR is an orally administered and well-tolerated medication in clinical use, it has promise for prophylaxis against stroke in patients at high risk of stroke.

Acute Cerebellar Syndrome, Conjunctivitis, and Hearing Loss Associated with Low-Dose Cytarabine Administration

1987 ◽  
Vol 21 (10) ◽  
pp. 798-803 ◽  
Author(s):  
Robert J. Cersosimo ◽  
Ricardo T. Carter ◽  
S. James Matthews ◽  
Maryann Coderre ◽  
Daniel D. Karp
Keyword(s):  
Hearing Loss ◽  
Low Dose ◽  
High Dose ◽  
Cerebellar Syndrome ◽  
Drug Induced ◽  
Myeloid Metaplasia ◽  
High Dose Cytarabine ◽  
Work Up ◽  
Low Dose Cytarabine ◽  
Nose And Throat

An unusual reaction associated with chronic low-dose cytarabine is described. A 77-year-old man complained of three to four weeks of hearing loss and progressive inability to walk without assistance. He had received two courses of cytarabine 100 mg sc/wk for the management of myelofibrosis myeloid metaplasia over 21 months. He received a total of 3 g over seven months during his first course followed ten months later with 1.2 g over four months. Conjunctivitis was also identified on physical examination at the time of his admission. He was admitted to the neurology service where a complete neurological work-up with consultations from the ophthalmology, audiology, hematology, and ear, nose, and throat services failed to identify a cause of his symptoms. Cytarabine was discontinued on the suspicion that his symptoms were drug induced. The conjunctivitis resolved completely with ophthalmic antibiotics and corticosteroids. His hearing slowly improved over three to four weeks, and he was able to ambulate with a walker. He continued to improve at home although some hearing loss remained three months after his initial presentation. Although conjunctivitis and neurotoxicity are well-known complications of high-dose cytarabine, there are no prior reports of these reactions after low-dose therapy. Hearing loss, which has not been previously reported with cytarabine alone, appears to be a new complication of cytarabine administration.

scholarly journals Transient Hiccups Associated with Oral Dexamethasone

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Mark E. Peacock
Keyword(s):  
Steroid Therapy ◽  
Side Effect ◽  
Surgical Procedure ◽  
Low Dose ◽  
Drug Induced ◽  
Potential Side Effect ◽  
Oral Dexamethasone ◽  
Potential Condition ◽  
High Doses

Hiccups, or singulata (hiccup is singultus), are commonly experienced by most people at one time or another and are usually brief and self-limiting. Although pharmacotherapeutic agents are not generally considered causal in the etiology of hiccups, many clinicians empirically associate episodic hiccups in their patients as being drug induced. The two classes of drugs most often cited as causing hiccups are corticosteroids and benzodiazepines. This report involved a patient who was given preoperative dexamethasone and developed hiccups before anesthesia and surgery commenced. He at no time was in distress, and the surgical procedure was completed without complication. By the second postsurgical day his hiccups were resolved completely. Although the association may be anecdotal, many clinicians consider hiccups a potential side effect of steroid therapy, especially high doses of steroids. Of interest in this case is the relatively low dose of corticosteroid used, albeit apparently linked to his hiccups. Practitioners should be aware of this potential condition.

Results of annual screening of lung cancer with low dose computed tomography in 5,000 high-risk individuals

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7566-7566
Author(s):  
G. Veronesi ◽  
M. Bellomi ◽  
L. Spaggiari ◽  
G. Pelosi ◽  
A. Sonzogni ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Low Dose ◽  
Pulmonary Nodules ◽  
Lung Cancers ◽  
Annual Screening ◽  
One Year ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

7566 Background: Screening detected lung cancers are correlated with good prognosis however most of the reported cases were detected at baseline screening and little is known about the evolution of pulmonary nodules at annual screening. We report the results of the first and second year of a single centre screening trial focusing the attention on the evolution of pulmonary nodules. Methods: The Cosmos trial started in October 2004 and enrolled 5,202 asymptomatic persons at high risk for lung cancer in one year. Between October 2005 and October 2006, the participants of the study, have been recalled to undergo the annual low dose CT. New lesions were treated according to the baseline diagnostic work up protocol. Previously detected lesions grown at annual screening were investigated with repeated low dose CT and/or Pet scan. Surgical biopsy was scheduled in case of Pet positive or growing nodules. Stable lesions were sent to one year follow up. Results: 4,745 out of 5,202 underwent the annual screening (compliance 92%). Recall rate was 10.7% at baseline and 4% at annual screening. Rate of malignant disease was 1.03% at baseline and 0.7% at annual screening. Patients with stage I disease were 68% at baseline and 76% at annual screening. Of the 32 lung cancers diagnosed at annual screening 8 were new nodules, 1 nodules was stable and 23 nodules progressed from the previous year. Among these, 9 nodules were lower than 5 mm at baseline (out of 2,190 subjects = 0.4%) and 14 were larger than 5 mm (out of 560 subjects =2.5%). Conclusions: Screening low dose spiral CT is an effective tool for the early detection of lung cancer. At first annual screening malignancy rate decreased from 1% to 0.7% and stage distribution was more favourable. However the high rate of delayed diagnosis (2.5%) in cases of nodules larger than 5 mm at baseline CT may require a revision of our proposed diagnostic work up protocol to further anticipate detection of these cases. No significant financial relationships to disclose.

Rapidly progressive glomerulonephritis as presenting feature of systemic lupus erythematosus in a Bangladeshi male patient: a rare case report

2020 ◽  
Vol 10 (2) ◽  
pp. 137-138
Author(s):  
Samiha Haque ◽  
Ishrat Jahan ◽  
Tufayel Ahmed Chowdhury ◽  
Muhammad Abdur Rahim ◽  
Mehruba Alam Ananna ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Venous Pressure ◽  
Rapidly Progressive Glomerulonephritis ◽  
Initial Response ◽  
Systemic Lupus ◽  
Renal Manifestation ◽  
Rare Case Report ◽  
Diagnostic Work ◽  
Work Up

Rapidly progressive glomerulonephritis is one of the most dramatic and tragic presentations of lupus nephritis (LN) or renal manifestation of systemic lupus erythematosus (SLE). A 35-year-old Bangladeshi gentleman presented with worsening oedema, scanty, high colored, frothy urine and deteriorating renal function. He had puffy face, anaemia, oedema, normal jugular venous pressure (JVP), high blood pressure (150/90 mm Hg), ascites and bilateral pleural effusions. Diagnostic work-up confirmed SLE with class IV LN. His initial response to specific therapy showed improvement Birdem Med J 2020; 10(2): 137-138

EFFECT OF HIGH DOSES OF OESTROGEN AND PROGESTERONE ON THE NORADRENALINE CONTENT OF THE SHORT ADRENERGIC NEURONS INNERVATING THE MALE GENITAL TRACT OF THE RAT

1970 ◽  
Vol 64 (3) ◽  
pp. 459-465 ◽  
Author(s):  
Ch. Owman ◽  
N.-O. Sjöberg ◽  
N. O. Sjöstrand ◽  
G. Swedin
Keyword(s):  
Genital Tract ◽  
Reproductive Tract ◽  
Female Genital Tract ◽  
Total Content ◽  
Prolonged Treatment ◽  
Noradrenaline Content ◽  
Adrenergic Neurons ◽  
Short Adrenergic Neurons ◽  
High Doses ◽  
Male Genital

ABSTRACT The effect of prolonged treatment with high doses of oestrogen and/or progesterone on the amount of adrenergic transmitter in the short adrenergic neurons of the male reproductive tract of castrated rats has been studied by chemical determinations and histochemical demonstration of noradrenaline. Oestrogen, progesterone, or a combination of both, had no overt effect on the total content or on the concentration of noradrenaline in the male genital organs. The results are discussed in the light of recent findings that the content of the noradrenaline transmitter in the short adrenergic neurons to the female genital tract is markedly influenced by these female sex hormones.

Sign in / Sign up

Export Citation Format

Share Document