Minocycline-Associated Tooth Staining

1998 ◽  
Vol 32 (9) ◽  
pp. 887-889 ◽  
Author(s):  
Melanie A Dodd ◽  
Ernest J Dole ◽  
William G Troutman ◽  
David A Bennahum
Keyword(s):  
Adverse Drug Reaction ◽  
White Woman ◽  
Pediatric Population ◽  
Anterior Teeth ◽  
Tooth Discoloration ◽  
Minocycline Treatment ◽  
Case Summary ◽  
Synthetic Derivative ◽  
Abnormal Pigmentation ◽  
Minocycline Therapy

OBJECTIVE: To describe a case of tooth discoloration in an adult after minocycline treatment for arthritis. CASE SUMMARY: A 68-year-old white woman presented with blue–black staining of her lower anterior teeth after 4 months of minocycline therapy for arthritis. Her other medications are not known to cause discoloration of teeth. While the patient continued taking minocycline, her dentist was not able to remove the discoloration. Within 1 month after discontinuation of the minocycline, the dentist was able to remove the discoloration entirely. DISCUSSION: Minocycline, a synthetic derivative of tetracycline, has been shown to cause abnormal pigmentation of the skin, thyroid gland, nails, bone, sclera, and conjunctiva in adults. It also has been shown to cause tooth discoloration in a few patients. This case is unusual in that the tooth discoloration disappeared after discontinuing minocycline therapy. CONCLUSIONS: This complication of minocycline is more commonly thought of in the pediatric population. However, clinicians need to be aware of this adverse drug reaction, as this agent may be used increasingly in the treatment of adults with arthritis.

Angioedema Associated with Aspirin and Rofecoxib

2005 ◽  
Vol 39 (5) ◽  
pp. 944-948 ◽  
Author(s):  
Leisa L Marshall
Keyword(s):  
White Woman ◽  
Skin Testing ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Aspirin Therapy ◽  
Probability Scale ◽  
Antiinflammatory Drugs ◽  
Case Summary ◽  
Cox 2 ◽  
Cox 2 Inhibitors ◽  
Auto Injector

OBJECTIVE: To report the probable association of angioedema with aspirin therapy and the selective cyclooxygenase-2 (COX-2) inhibitor rofecoxib. CASE SUMMARY: A 44-year-old white woman, previously tolerant to aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs), developed angioedema of the lips after ingesting two 325-mg aspirin tablets during one day. The reaction occurred 3 hours after taking the second aspirin and resolved within 3 hours. Two weeks later, the patient took a 25-mg rofecoxib tablet for a sore throat, and she developed angioedema 51/2 hours later. Although the woman took 50 mg of diphenhydramine, the swelling did not subside. She repeated the diphenhydramine dose in the evening and, by noon the next day, 261/2 hours after the angioedema began, it was resolved. The patient's internist prescribed an epinephrine auto-injector and advised her to consult an allergist. With skin testing and oral rechallenge with aspirin, but not rofecoxib, the allergist determined the cause of the reactions to be aspirin-induced angioedema and selective COX-2 inhibitor intolerance. The Naranjo probability scale indicated that aspirin was a highly probable cause and rofecoxib was a probable cause of this patient's angioedema. DISCUSSION: Aspirin-induced angioedema and NSAID intolerance have been well documented. There are reports of both tolerance and intolerance to selective COX-2 inhibitors in patients with documented allergy-like reactions to aspirin and NSAIDs. CONCLUSIONS: Patients with aspirin and NSAID intolerance may develop intolerance to COX-2 inhibitors, especially with repeated exposure.

Hyponatremia with Venlafaxine

1998 ◽  
Vol 32 (1) ◽  
pp. 49-51 ◽  
Author(s):  
Gule Rana Masood ◽  
Shyam D Karki ◽  
William R Patterson
Keyword(s):  
Serotonin Reuptake ◽  
White Woman ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Temporal Relationship ◽  
Potential Problem ◽  
Potent Inhibitor ◽  
Hormone Secretion ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Case Summary

OBJECTIVE To describe a patient with hyponatremia associated with venlafaxine therapy. CASE SUMMARY: A 92-year-old white woman who was receiving venlafaxine for management of depression was found to have hyponatremia. A detailed workup confirmed the diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). A temporal relationship between initiation of venlafaxine therapy and the onset of hyponatremia indicated it as the probable cause. Venlafaxine was discontinued, and hyponatremia resolved within a few weeks. DISCUSSION: Hyponatremia has been reported with selective serotonin-reuptake inhibitors (SSRIs). Serotonin has been reported to elevate concentrations of vasopressin in animal models. Venlafaxine is a potent inhibitor of serotonin reuptake and may have adverse effects similar to those of SSRIs. CONCLUSIONS We report a case of hyponatremia probably caused by venlafaxine. Awareness of this potential problem would be helpful to clinicians and should be considered in the differential diagnosis of hyponatremia. OBJETIVO Informar el caso de un paciente con hiponatremia asociada al tratamiento con venlafaxine. RESUMEN Una mujer de 92 años en tratamiento con venlafaxine para el manejo de depresión desarrolló hiponatremia. Sus otros medicamentos concurrentes incluían fenobarbital 120 mg al acostarse, enalapril 10 mg/d, furosemida 20 mg/d, carbonato de calcio 650 mg dos veces al día, y nortriptilina 50 mg al acostarse. Una evaluación detallada confirmó el diagnóstico del síndrome inadecuado de la hormona antidiurética. La relación temporal entre el inicio del tratamiento con venlafaxine y el inicio de la hiponatremia tiende a señalar a este medicamento como el causante. Al descontinuar el venlafaxine la hiponatremia se resolvió en unas pocas semanas. DISCUSIÓN La hiponatremia ha sido asociada con los inhibidores selectivos de la recaptación de serotonina (ISRS). En modelos de animales se ha demostrado que la serotonina eleva los niveles de vasopresina. Venlafaxine es un inhibidor potente de la recaptación de serotonina y puede tener efectos adversos similares a los de los ISRS. CONCLUSIONES: Se informó un caso de hiponatremia probablemente causada por venlafaxine. Desde que se sometió este informe han sido publicados tres informes similares de hiponatremia atribuídos a este antidepresivo. Esto sugiere que venlafaxine puede causar hiponatremia. vasopresina. Venlafaxine es un inhibidor potente de la recaptación de serotonina y puede tener efectos adversos similares a los de los ISRS. CONCLUSIONES: Se informó un caso de hiponatremia probablemente causada por venlafaxine. Desde que se sometió este informe han sido publicados tres informes similares de hiponatremia atribuídos a este antidepresivo. Esto sugiere que venlafaxine puede causar hiponatremia. Este hecho debe ser considerado al hacer el diagnóstico diferencial de cualquier paciente que desarrolle hiponatremia mientras esté utilizando este medicamento. Este hecho debe ser considerado al hacer el diagnóstico diferencial de cualquier paciente que desarrolle hiponatremia mientras esté utilizando este medicamento.

Successful Desensitization to Oxaliplatin

2005 ◽  
Vol 39 (5) ◽  
pp. 966-969 ◽  
Author(s):  
Lydia ◽  
Nishan H Fernando ◽  
Hurbert I Hurwitz ◽  
Michael A Morse
Keyword(s):  
White Woman ◽  
Initial Response ◽  
Response To Therapy ◽  
Controlled Environment ◽  
Metastatic Colon Cancer ◽  
Hypersensitivity Reactions ◽  
Platinum Compounds ◽  
Probability Scale ◽  
Case Summary ◽  
Life Threatening

OBJECTIVE: To report the successful desensitization of a patient to oxaliplatin utilizing an 8-hour desensitization regimen in a controlled environment. CASE SUMMARY: A 53-year-old white woman with metastatic colon cancer was receiving oxaliplatin, bevacizumab, and capecitabine every 2 weeks, with a partial response to therapy. On her fifth cycle of this regimen, she experienced diaphoresis, hypotension, nausea, abdominal cramping, and coryza. According to the Naranjo probability scale, oxaliplatin, and not bevacizumab, was the probable cause of the hypersensitivity reaction. The woman continued therapy with capecitabine and bevacizumab, resulting in stable disease. Due to her initial response to the oxaliplatin-based regimen, it was decided to attempt desensitization to oxaliplatin in a controlled, inpatient environment. An 8-hour desensitization schedule was employed, and the patient successfully completed an additional 3 cycles with full-dose oxaliplatin. DISCUSSION: Hypersensitivity reactions to platinum-containing compounds are well described and potentially life threatening. With expanded use of oxaliplatin in various malignancies, an increased number of hypersensitivity reactions will likely be reported. Patients with previous hypersensitivity reactions to carboplatin are at risk for similar reactions to oxaliplatin. We achieved successful desensitization for oxaliplatin using increased concentrations of the drug over an 8-hour period concomitant with oral and intravenous corticosteroids and histamine blockers. CONCLUSIONS: Hypersensitivity reactions to platinum compounds may result in discontinuation of active therapies in patients with metastatic disease. Desensitization to oxaliplatin is possible utilizing this approach.

Ifosfamide-Induced Nonconvulsive Status Epilepticus

1995 ◽  
Vol 29 (12) ◽  
pp. 1237-1239 ◽  
Author(s):  
Ashwani Bhardwaj ◽  
Pritam S Badesha
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Status Epilepticus ◽  
Temporal Relationship ◽  
Pediatric Population ◽  
Laboratory Data ◽  
Nonconvulsive Status Epilepticus ◽  
Case Summary ◽  
History Of ◽  
Clonic Seizures

Objective: To describe a patient with ifosfamide-induced nonconvulsive status epilepticus. Case Summary: A 71-year-old woman with a history of malignant mixed mesodermal tumor involving the uterus, cervix, and vagina was admitted because of local recurrence. After receiving 3 doses of ifosfamide/mesna, she was found to be unresponsive. Physical examination and laboratory data revealed no significant changes. An electroencephalogram was consistent with the diagnosis of nonconvulsive status epilepticus. The patient's mental status returned to baseline after treatment with intravenous phenytoin and discontinuation of ifosfamide therapy. Discussion: Central nervous system (CNS) toxicity has been described with ifosfamide, with most cases reported in the pediatric population. Among CNS toxicities, generalized tonic-clonic seizures have been reported in both children and adults. This represents the first report of nonconvulsive status epilepticus induced by ifosfamide. Conclusions: There was a temporal relationship between the onset of nonconvulsive status epilepticus and initiation of ifosfamide infusion. No other identifiable factor contributed to the unresponsiveness.

scholarly journals Whitening of a Non-Vital Tooth with Walking Bleach Technique: A Case Series

2021 ◽  
Vol 5 (2) ◽  
pp. CR1-CR5
Author(s):  
Deepika ◽  
Muhammad Mutiur Rahman ◽  
Ajay Kumar Nagpal
Keyword(s):  
Hydrogen Peroxide ◽  
Case Series ◽  
Sodium Perborate ◽  
Endodontically Treated Teeth ◽  
Efficient Treatment ◽  
Chemical Substances ◽  
Significant Aspect ◽  
Oxidizing Agents ◽  
Anterior Teeth ◽  
Tooth Discoloration

A significant aspect of cosmetic dentistry is the treatment of tooth discoloration. Discoloration of non-vital anterior teeth can cause significant esthetic concern and requires efficient treatment. Discoloration of teeth can be extrinsic or intrinsic or a combination of both based on etiology, appearance, localization, and severity. Walking bleach involves the use of chemical substances like sodium perborate or hydrogen peroxide which in contact with the tooth release oxidizing agents that diffuse through the enamel and dentin and oxidize the pigments responsible for discoloration. This article aims at presenting a case series on the walking bleach method performed on discolored endodontically treated teeth associated with superior esthetic outcomes.

scholarly journals Perbedaan efektivitas jus tomat (Lucopersicon esculentum Mill.) dan jus apel (Mallus sylvestris Mill.) sebagai bahan alami pemutih gigi

e-GIGI ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Enny F. S. Lumuhu ◽  
Martha M. Kaseke ◽  
Wulan G. Parengkuan
Keyword(s):  
Apple Juice ◽  
Color Change ◽  
Human Interaction ◽  
Tomato Juice ◽  
Control Group ◽  
Carbamide Peroxide ◽  
Control Group Design ◽  
Anterior Teeth ◽  
Tooth Discoloration ◽  
Significant Difference

Abstract: Teeth appearance plays an important role in human interaction. One of its problems is tooth discoloration which can affect personal self confidence and appearance. Chemicals for whitening the teeth can cause negative effects such as decreased enamel hardness and gingival iritaion. An alternative material that can be used for that purpose is natural substance inter alia tomato juice (Lucopersicon esculentum Mill.) which contains hydrogen peroxide and apple juice (Mallus sylvestris Mill.) which contains malic acid. This study aimed to determine the difference in effectiveness of tomato juice and apple juice as natural bleaching agents. This was a true experimental study with a pretest postest only control group design. There were 30 samples of post-extraction anterior teeth soaked in coffee for 12 days and were further divided into 3 groups, each of 10 samples. Group 1 was immersed in tomato juice; group 2 was immersed in apple juice; and group 3 as the positive control was immersed in carbamide peroxide 10%. Each group was observed after 1 day, 3 days, and 5 days. The color change was measured by using CIEL*a*b method. The results showed that tomato juice, apple juice, and carbamide peroxide 10% could whiten the teeth. However, tomato juice was more effective compared to apple juice and carbamide peroxide 10%. Apple juice and carbamide peroxide 10% did not show any significant difference in color change. Keywords: tomato juice, apple juice, carbamide peroxide 10%, tooth discolorationAbstrak: Penampilan gigi berperan dalam interaksi manusia. Masalah dalam penampilan gigi salah satunya ialah perubahan warna gigi yang dapat memengaruhi kepercayaan diri dan keindahan penampilan seseorang. Penggunaan bahan kimia untuk memutihkan gigi dapat berdampak negatif seperti penurunan kekerasan email dan iritasi gingiva. Bahan alternatif yang dapat digunakan untuk memutihkan gigi yaitu dengan bahan alami antara lain jus tomat (Lucopersicon esculentum Mill.) yang mengandung hidrogen peroksida dan jus apel (Mallus sylvestris Mill.) yang mengandung asam malat. Penelitian ini bertujuan untuk mengetahui perbedaan efektivitas jus tomat dan jus apel sebagai bahan alami pemutih gigi. Terdapat 30 sampel gigi anterior pasca ekstraksi yang direndam kopi selama 12 hari. Sampel dibagi menjadi 3 kelompok masing-masing terdiri dari 10 sampel. Kelompok 1 direndam dalam jus tomat; kelompok 2 direndam dalam jus apel; dan kelompok 3 sebagai kontrol positif menggunakan karbamid peroksida 10%. Setiap kelompok dilakukan pengamatan 1 hari, 3 hari dan 5 hari. Perubahan warna diukur menggunakan metode CIEL*a*b. Hasil penelitian mendapatkan jus tomat, jus apel, dan karbamid peroksida 10% dapat memutihkan gigi. Jus tomat lebih efektif memutihkan gigi dibandingkan jus apel dan karbamid peroksida 10%. Jus apel dan karbamid peroksida 10% tidak memiliki perbedaan memutihkan gigi yang signifikan.Kata kunci: jus tomat, jus apel, karbamid peroksida 10%, perubahan warna gigi

Minocycline-Induced Lupus

1997 ◽  
Vol 31 (10) ◽  
pp. 1160-1163 ◽  
Author(s):  
Debra K Farver
Keyword(s):  
Case Report ◽  
Antinuclear Antibody ◽  
Healthcare Providers ◽  
Antibody Test ◽  
Drug Induced ◽  
White Girl ◽  
Case Summary ◽  
Data Source ◽  
Minocycline Therapy ◽  
Unusual Symptoms

OBJECTIVE: To report a case of drug-induced lupus occurring 5 months after the initiation of minocycline therapy for acne. DATA SOURCE: Case report information was obtained from the physician, patient's family, and the medical record. MEDLINE and Index Medicus were searched to obtain relevant published literature from 1966 to 1996. CASE SUMMARY: A 14-year-old white girl developed symptoms of myalgias, arthralgias, polyarthritis, and flushed face. The antinuclear antibody test was positive. Minocycline was discontinued and the patient's condition dramatically improved within 7 days. CONCLUSIONS: Healthcare providers should recognize early common and unusual symptoms of minocycline-induced lupus in adolescents being treated for acne.

Carbimazole-Related Gastroschisis

2003 ◽  
Vol 37 (6) ◽  
pp. 829-831 ◽  
Author(s):  
Anne-Maëlle Guignon ◽  
Michel P Mallaret ◽  
Pierre Simon Jouk
Keyword(s):  
Abdominal Wall ◽  
White Woman ◽  
Surgical Repair ◽  
Causality Assessment ◽  
In Utero ◽  
Abdominal Wall Defects ◽  
Rare Occurrence ◽  
Case Summary ◽  
The Relationship ◽  
Malformative Syndrome

OBJECTIVE: To report a case of gastroschisis in a newborn secondary to carbimazole exposure in utero. CASE SUMMARY: A 25-year-old white woman was treated for Graves disease with carbimazole throughout pregnancy. A boy was born prematurely by vaginal delivery, with a gastroschisis without associated malformative syndrome. Death occurred in the 25th hour of life after surgical repair. DISCUSSION: Carbimazole is completely metabolized to methimazole after absorption. Carbimazole or methimazole intake during pregnancy has been associated with an increased incidence of scalp aplasia. Abdominal wall defects secondary to carbimazole or methimazole exposure in utero seem to be a rare occurrence. However, other cases of abdominal wall defects have been reported in 4 newborns, 2 of them associated with scalp aplasia. An objective causality assessment revealed that the relationship between the gastroschisis and the exposure to carbimazole in utero was possible. CONCLUSIONS: It is important to emphasize the possible risk of abdominal wall defects in newborns to pregnant women taking carbimazole or methimazole.

Leflunomide-Associated Skin Ulceration

2002 ◽  
Vol 36 (6) ◽  
pp. 1009-1011 ◽  
Author(s):  
Christopher M McCoy
Keyword(s):  
Rheumatoid Arthritis ◽  
White Woman ◽  
Ethinyl Estradiol ◽  
Drug Effect ◽  
Methotrexate Therapy ◽  
Leg Ulcers ◽  
Skin Ulceration ◽  
Skin Breakdown ◽  
Case Summary ◽  
History Of

OBJECTIVE: To report a case of skin ulceration as a result of treatment with leflunomide for rheumatoid arthritis. CASE SUMMARY: A 78-year-old white woman developed bilateral leg ulcers after 6 months of treatment with leflunomide for rheumatoid arthritis. A history of leg ulcers after methotrexate therapy had been documented. Serologic and diagnostic tests did not support an alternate process. Other medications prescribed were oral ethinyl estradiol 0.05 mg/d, felodipine 5 mg/d, and paroxetine 20 mg/d, for which no documented correlation with the skin breakdown could be made. DISCUSSION: This is the first published case describing a possible relationship between the use of the immunosuppressant agent leflunomide and skin ulceration. CONCLUSIONS: Skin breakdown and ulceration is a recognized adverse effect of drugs with immunosuppressant activity such as methotrexate. Leflunomide, a newer agent prescribed in the treatment of rheumatoid arthritis, may now be listed among the drugs in this category associated with this adverse drug effect.

Mechanisms for Linezolid-Induced Anemia and Thrombocytopenia

2003 ◽  
Vol 37 (4) ◽  
pp. 517-520 ◽  
Author(s):  
Wendy B Bernstein ◽  
Richard F Trotta ◽  
James T Rector ◽  
Jeffery A Tjaden ◽  
Anthony J Barile
Keyword(s):  
Heart Failure ◽  
Staphylococcus Epidermidis ◽  
White Woman ◽  
Causality Assessment ◽  
Drug Event ◽  
Ringed Sideroblasts ◽  
Case Summary ◽  
Immune Mediated ◽  
Linezolid Therapy ◽  
Rate Of Decline

BACKGROUND: Linezolid has been associated with anemia and thrombocytopenia. Mechanisms for neither have been elucidated. OBJECTIVE: To propose mechanisms for linezolid-induced anemia and thrombocytopenia. CASE SUMMARY: A 78-year-old white woman with Staphylococcus epidermidis endocarditis was treated with linezolid after developing resistance to multiple antibiotic regimens. After 7 days of linezolid therapy, she developed thrombocytopenia, while an anemia present since admission remained unchanged. A bone marrow biopsy was performed, primarily looking for a mechanism for the thrombocytopenia. Histopathology revealed adequate megakaryocytes, ringed sideroblasts, and vacuolated pronormoblasts. A course of immune globulin (IVIG) was administered, with slowing in the rate of decline in platelets. She died 24 hours after her last dose of IVIG of congestive heart failure. DISCUSSION: The presence of ringed sideroblasts and vacuolated pronormoblasts suggests that linezolid-induced anemia is secondary to a chloramphenicol-like suppression of erythropoiesis. The presence of adequate, normal-appearing megakaryocytes suggests immune-mediated thrombocytopenia, not marrow suppression. Although the response to IVIG is difficult to interpret because of the patient's death, there was a slowing in the rate of decline of the platelet count, further supporting immune-mediated thrombocytopenia. An objective causality assessment indicated that the adverse drug event was probably due to linezolid. CONCLUSIONS: There appear to be 2 distinct mechanisms for linezolid-induced cytopenias. While anemia is reversible and manageable with transfusions, thrombocytopenia can be a treatment-limiting toxicity. The ability to treat through an immune-mediated cytopenia with IVIG may be beneficial for critically ill patients with few therapeutic options.

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