1.
Poisoning by Coriaria myrtifolia Linnaeus: a new case report and review of the literature.
de Haro, L, Pommier, P, Tichadou, L, Hayek-Lanthois, M, Arditti, J
Toxicon : official journal of the International Society on Toxinology. 2005;(6):600-3
Abstract
Coriaria myrtifolia should be recognized as one of the most neurotoxic plants in western Mediterranean area. This shrub produces a toxin, coriamyrtin, that is present in high concentrations in the berries. Ingestion of few fruits similar to blackberries may induce digestive and neurological manifestations including seizures, coma and apnea. The authors present a new case report that took place in the French Catalonia: an 8 year-old boy developed vomiting and generalized recurrent convulsions after ingestion of C. myrtifolia berries. He needed repeated diazepam administrations and was managed in the hospital. He recovered after one day of benzodiazepine treatment. In order to evaluate the consequences of C. myrtifolia poisoning, 83 cases of the literature were analyzed: the cases occurred in three countries (Spain, France and Morocco); the mean delay of the symptom development was 150 min; the neurological disturbances were the most frequent signs and 11 patients died (6 children, 5 adults) mainly in old reports.
2.
Obesity in transplant patients: case report showing interference of orlistat with absorption of cyclosporine and review of literature.
Barbaro, D, Orsini, P, Pallini, S, Piazza, F, Pasquini, C
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2002;(2):124-6
Abstract
OBJECTIVE To report a case of an obese patient who had undergone renal transplantation and who had subtherapeutic levels of serum cyclosporine after treatment with orlistat. METHODS The clinical and laboratory findings are presented, and the few cases reported in the literature are reviewed. RESULTS A 29-year-old woman had subtherapeutic plasma levels of cyclosporine after orlistat treatment (360 mg/day) was initiated. The subtherapeutic levels persisted even though orlistat was administered the recommended 2 hours before ingestion of cyclosporine and even though the dosage of orlistat was decreased to only 240 mg/day. Because an increase of body weight is common after organ transplantation, treatment with orlistat has been used. In such patients, however, six cases of reduced therapeutic plasma levels of cyclosporine have been reported. Although a drug-drug interaction has been suggested, this case suggests that the decreased plasma cyclosporine levels are due to reduced absorption of fats rather than a drug-drug interaction. Because this patient was unable to adhere to a low-fat diet, she experienced severe diarrhea, a factor that may have dramatically diminished the absorption of cyclosporine. CONCLUSION Adherence to a low-fat diet should be strongly recommended if orlistat is prescribed to patients taking cyclosporine. Moreover, strict surveillance of the plasma concentration of cyclosporine is important.
3.
Cyclooxygenase-2 inhibitor-associated acute renal failure: case report with rofecoxib and review of the literature.
Morales, E, Mucksavage, JJ
Pharmacotherapy. 2002;(10):1317-21
Abstract
Cyclooxygenase (COX)-2 inhibitors are widely prescribed for their antiinflammatory and analgesic effects. The potential for COX-2 inhibitors to exert deleterious effects on renal function similar to those of traditional nonsteroidal antiinflammatory drugs is not well defined. Until recently, COX-1 was considered responsible for the synthesis of renal prostaglandins. However, COX-2 is also constitutively expressed in the human kidney Clinical studies have reported a significant decrease in glomerular filtration rate in young and elderly sodium-depleted volunteers given COX-2 inhibitors. We describe the case of a 71-year-old woman who developed acute renal failure after receiving a 50-mg dose of the selective COX-2 inhibitor rofecoxib.