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Hypersensitivity reactions to bicarbonate dialysate containing acetate: a case report with literature review.
Nishiuchi, Y, Shima, H, Fukata, Y, Tao, T, Okamoto, T, Takamatsu, N, Okada, K, Minakuchi, J
CEN case reports. 2020;(3):243-246
Abstract
Although hemodialysis-hypersensitivity reactions have various causes, only a few cases of hypersensitivity to acetate dialysate accompanied by fever have been reported. We present the case of a 69-year-old hemodialysis patient who was admitted due to fever after dialysis. He had undergone online hemodiafiltration using acetate-free citrate-containing dialysate. After admission, we switched to acetate-containing bicarbonate dialysate. He was diagnosed with pneumonia and treated with ceftriaxone. However, fever that occurred post dialysis persisted, displaying a gradual elevation in CRP level and eosinophils (up to 9.7 mg/dL and 3774 cells/μL, respectively). After a series of negative workups for infection and dialysis membrane allergy, we suspected that acetate-containing bicarbonate dialysate to be the cause of the allergic reaction and switched to acetate-free bicarbonate dialysate. Consequently, eosinophil count decreased and the fever abated. The drug-induced lymphocyte stimulation test finding (for acetate dialysate) was positive, and he was diagnosed with acetate dialysate-induced hypersensitivity reactions. The condition was not detected earlier due to the complications associated with pneumonia.
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2.
Telangiectasia macularis eruptive perstans (TMEP) in childhood: a case report and literature review.
Leonardi, S, Vitaliti, G, Praticò, AD, La Rosa, M
Allergologia et immunopathologia. 2012;(5):321-3
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3.
Therapeutic Hotline: Cysteinyl leukotriene receptor antagonist montelukast in the treatment of atopic dermatitis.
Broshtilova, V, Gantcheva, M
Dermatologic therapy. 2010;(1):90-3
Abstract
Leukotrienes are potent proinflammatory mediators derived from arachidonic acid through the 5-lipoxygenase pathway. Experimental data suggest a role for cysteinyl leukotrienes in the pathogenesis of atopy giving a rationale for its use in asthma, allergic rhinitis, and chronic urticaria management. A few clinical observations and small trials suggest that montelukast may be used in an adjunctive manner as an effective therapeutic option for all age categories affected by moderate-to-severe atopic dermatitis. Our own observations proved that montelukast as a prospective corticosteroid-sparing option in the complex therapeutic strategy of corticosteroid-dependent atopic dermatitis patients, even in the severe erythrodermic cases.
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4.
Churg-Strauss syndrome associated with montelukast therapy.
Girszyn, N, Amiot, N, Lahaxe, L, Cuvelier, A, Courville, P, Marie, I
QJM : monthly journal of the Association of Physicians. 2008;(8):669-71
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5.
Gabapentin for intractable hiccup.
Hernández, JL, Pajarón, M, García-Regata, O, Jiménez, V, González-Macías, J, Ramos-Estébanez, C
The American journal of medicine. 2004;(4):279-81
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6.
Gabapentin for painful legs and moving toes syndrome.
Villarejo, A, Porta-Etessam, J, Camacho, A, González De La Aleja, J, Martínez-Salio, A, Penas, M
European neurology. 2004;(3):180-1
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7.
Gabapentin attenuates superior oblique myokymia.
Tomsak, RL, Kosmorsky, GS, Leigh, RJ
American journal of ophthalmology. 2002;(5):721-3
Abstract
PURPOSE To investigate therapeutic effects of oral gabapentin therapy on superior oblique myokymia. DESIGN Observational case series with measurement of visual acuity and eye movements before, during, and after therapy. METHODS Two adult patients with superior oblique myokymia, refractory to other therapies, were treated with gabapentin orally after informed consent was obtained. Eye movements were measured using the magnetic search coil technique. RESULTS Superior oblique myokymia completely resolved after starting gabapentin. CONCLUSION Gabapentin may be an effective treatment for superior oblique myokymia; a double-blind study seems justified.
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8.
Churg-Strauss syndrome in two patients receiving montelukast.
Guilpain, P, Viallard, JF, Lagarde, P, Cohen, P, Kambouchner, M, Pellegrin, JL, Guillevin, L
Rheumatology (Oxford, England). 2002;(5):535-9
Abstract
OBJECTIVE Churg-Strauss syndrome (CSS) has been described in association with the treatment of asthmatic patients with leukotriene receptor antagonist. The main mechanism proposed to explain this condition is the unmasking of CSS after the leukotriene receptor antagonist has allowed corticosteroid tapering. Other hypotheses might be proposed. METHODS We describe two patients who developed CSS after starting treatment with montelukast, a new antileukotriene drug. RESULTS Both patients presented with CSS after 4-5 months of treatment with montelukast. Neither patient received long-term systemic steroids for asthma, but both were on inhaled steroids. One patient had a myocardial involvement and experienced a stroke. Our two patients were treated with systemic steroids and cyclophosphamide. CONCLUSIONS CSS does not appear to relate to steroid tapering in our patients. The other hypotheses are a coincidence or a direct adverse effect of the antileukotriene. Long-term data on these drugs are lacking and leukotriene's role in vasculitis remains to be elucidated.
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9.
[Treatment of asthma with antileukotrienes and Churg-Strauss syndrome].
Sala Félix, J, Pereiro Alonso, ME, Salas Antón, C
Archivos de bronconeumologia. 2001;(1):48-50
Abstract
Since antileukotriene treatment for asthma was introduced, there has been debate about whether such therapy can lead to Churg-Strauss Syndrome (CSS) or whether CSS is simply inhibited by the use of steroids, as various authors have suggested. We report a case in which we suspected CSS in a patient with bronchopulmonary, cutaneous and analytical signs and whom we treated with oral steroids. After clinical improvement, one year later, steroids were replaced by antileukotrienes, after which the same clinical picture developed. The vasculitis characteristic of CSS was confirmed pathologically.
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10.
[Churg-Strauss syndrome associated with montelukast therapy].
Sabadell, C, Jolis, R, Canalías, J
Medicina clinica. 2001;(4):159