Asunto(s)
Anticuerpos Monoclonales Humanizados , Erupciones por Medicamentos , Psoriasis , Humanos , Anticuerpos Monoclonales Humanizados/efectos adversos , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/patología , Psoriasis/tratamiento farmacológico , Psoriasis/inducido químicamente , Psoriasis/patología , Antineoplásicos Inmunológicos/efectos adversos , Exantema/inducido químicamente , Exantema/patología , Masculino , Femenino , AncianoRESUMEN
BACKGROUND Cutaneous adverse drug reactions are the skin's response to a systemic exposure to drugs. Linezolid is an oral oxazolidine used to treat methicillin-resistant Staphylococcus aureus infections. Even though it has well-known adverse effects, purpuric cutaneous adverse drug reactions to linezolid have been scarcely described. This report is of a Puerto Rican man in his 80s who developed an extensive purpuric drug eruption secondary to linezolid use. Clinicians should be aware of this phenomenon, since prompt identification and discontinuation of the agent are essential for recovery. CASE REPORT An 89-year-old Puerto Rican man was given oral linezolid therapy for healthcare-associated pneumonia and developed a widespread, purpuric cutaneous eruption 5 days into therapy. His condition prompted immediate discontinuation of the drug. Forty-eight hours after stopping the medication, he visited the Emergency Department. Abdominal punch biopsy revealed a superficial and perivascular lymphocytic infiltrate with dermal eosinophils, a pathologic finding consistent with a purpuric drug eruption. This allowed for a timely diagnosis, exclusion of other mimickers, such as cutaneous vasculitis, and effective management. CONCLUSIONS Cutaneous adverse drug reactions to linezolid have been scarcely reported in the literature. Due to the low incidence of this manifestation, the identification of the causative agent and accompanying treatment may be delayed. Mainstays in therapy are avoidance of the offending agent and treatment with corticosteroids, antihistamines, barrier ointments, and oral analgesics. Primary healthcare providers should be aware of linezolid-induced cutaneous manifestations, diagnostic clues, and treatment options so they can rapidly identify and effectively treat such complications.
Asunto(s)
Erupciones por Medicamentos , Exantema , Staphylococcus aureus Resistente a Meticilina , Púrpura , Vasculitis , Masculino , Humanos , Anciano de 80 o más Años , Linezolid/efectos adversos , Púrpura/inducido químicamente , Púrpura/complicaciones , Púrpura/patología , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/patología , Vasculitis/complicacionesRESUMEN
We report the case of a woman who started with a lichenoid eruption, unfavorable evolution, for which a drug reaction was suspected. The final diagnosis was paraneoplastic pemphigus. Multidisciplinary care and evaluation by an Allergist is important in patients with severe skin reactions, suspected of drug reactions, due to the difficulty in establishing the diagnosis.
Se reporta el caso de una mujer que inició con erupción liquenoide, con evolución desfavorable, por lo que se sospechó una reacción medicamentosa. El diagnóstico final fue pénfigo paraneoplásico. Es importante la atención multidisciplinaria y la evaluación de un alergólogo en pacientes con reacciones cutáneas graves, por sospecha de reacciones farmacológicas, debido a la dificultad para establecer el diagnóstico.
Asunto(s)
Erupciones por Medicamentos , Erupciones Liquenoides , Síndromes Paraneoplásicos , Pénfigo , Femenino , Humanos , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/etiología , Erupciones Liquenoides/diagnóstico , Síndromes Paraneoplásicos/diagnóstico , Pénfigo/diagnóstico , PielAsunto(s)
Erupciones por Medicamentos , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Liquen Plano , Erupciones Liquenoides , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Pravastatina/efectos adversos , Erupciones por Medicamentos/etiología , Erupciones Liquenoides/inducido químicamenteRESUMEN
Lithium is a mood stabilizer recommended by most clinical guidelines as the gold standard to prevent relapses in the treatment of Bipolar Affective Disorder. It is highly effective, but unfortunately, it causes adverse effects at several levels, including the skin. AIM: To review the frequency, presentation, evolution, and management of adverse dermatologic effects caused by this drug. METHODS: We performed a narrative review using Scielo, Web of Science (WoS), and Google Scholar search engines, using keywords in Spanish and English. RESULTS: The skin presentations that appear most frequently are the progression of previously existing or newly diagnosed psoriasis, alopecia, acne, follicular inflammation, and maculopapular eruptions. CONCLUSIONS: Lithium produces and/or exacerbates a series of dermatological conditions of different severity, even at therapeutic levels, which are not usually severe but, even so, should not be underestimated since it can affect adherence to the drug.
Asunto(s)
Trastorno Bipolar , Humanos , Trastorno Bipolar/tratamiento farmacológico , Compuestos de Litio/efectos adversos , Antimaníacos/efectos adversos , Antimaníacos/uso terapéutico , Erupciones por Medicamentos/etiología , Enfermedades de la Piel/inducido químicamenteRESUMEN
BACKGROUND: Immune checkpoint inhibitors (ICI) have been associated with several immune-related adverse events, including sarcoidosis-like reactions (SLR). SLR, which has a low prevalence but an increasing incidence, is similar to sarcoidosis in terms of histology, and clinical and radiological manifestations. The most commonly affected organs are hilar and mediastinal lymph nodes and skin. SLR is an exclusion diagnosis, so a lymph node biopsy can be useful to distinguish between tumor progression and SLR, particularly in tumors in which nodal involvement is very common. PATIENTS AND METHODS: We performed a retrospective analysis of SLR in all cancer patients receiving ICIs in our institution between January 2016 and June 2020. RESULTS: Among the 1063 treated patients, seven experienced SLR, four of whom were symptomatic (cough, skin lesions, arthralgia), with time to onset ranging from 1.5 to 6.7 months after ICI initiation. All seven patients had bilateral hilar lymphadenopathy, and granulomatous reactions in five of the six patients with lymph node biopsies. SLR improved in all patients, including four patients who continued with ICI. Three patients received corticosteroids and/or stopped ICI therapy. Four of these patients had partial responses at the time SLR was identified. CONCLUSION: Management of SLR lacks a consensus recommendation, although corticosteroids and/or stopping the ICI are generally implemented. The potential consequences of stopping anticancer treatment should be taken into consideration, particularly in the absence of clear management recommendations.
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Erupciones por Medicamentos/etiología , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Linfadenopatía/inducido químicamente , Neoplasias/tratamiento farmacológico , Sarcoidosis/inducido químicamente , Adulto , Anciano , Femenino , Hospitales , Humanos , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , EspañaRESUMEN
Intolerance is the most common reason for kinase inhibitor (KI) discontinuation in chronic lymphocytic leukemia (CLL). Umbralisib, a novel highly selective phosphatidylinositol 3-kinase δ (PI3Kδ)/CK1ε inhibitor, is active and well tolerated in CLL patients. In this phase 2 trial (NCT02742090), umbralisib was initiated at 800 mg/d in CLL patients requiring therapy, who were intolerant to prior BTK inhibitor (BTKi) or PI3K inhibitor (PI3Ki) therapy, until progression or toxicity. Primary end point was progression-free survival (PFS). Secondary end points included time to treatment failure and safety. DNA was genotyped for CYP3A4, CYP3A5, and CYP2D6 polymorphisms. Fifty-one patients were enrolled (44 BTKi intolerant and 7 PI3Kδi intolerant); median age was 70 years (range, 48-96), with a median of 2 prior lines of therapy (range, 1-7), 24% had del17p and/or TP53 mutation, and 65% had unmutated IGHV. Most common adverse events (AEs) leading to prior KI discontinuation were rash (27%), arthralgia (18%), and atrial fibrillation (16%). Median PFS was 23.5 months (95% CI, 13.1-not estimable), with 58% of patients on umbralisib for a longer duration than prior KI. Most common (≥5%) grade ≥3 AEs on umbralisib (all causality) were neutropenia (18%), leukocytosis (14%), thrombocytopenia (12%), pneumonia (12%), and diarrhea (8%). Six patients (12%) discontinued umbralisib because of an AE. Eight patients (16%) had dose reductions and were successfully rechallenged. These are the first prospective data to confirm that switching from a BTKi or alternate PI3Ki to umbralisib in this BTKi- and PI3Ki-intolerant CLL population can result in durable well-tolerated responses.
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Antineoplásicos/uso terapéutico , Fosfatidilinositol 3-Quinasa Clase I/antagonistas & inhibidores , Compuestos Heterocíclicos de 4 o más Anillos/uso terapéutico , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Proteínas de Neoplasias/antagonistas & inhibidores , Inhibidores de Proteínas Quinasas/uso terapéutico , Adenina/efectos adversos , Adenina/análogos & derivados , Adenina/uso terapéutico , Agammaglobulinemia Tirosina Quinasa/antagonistas & inhibidores , Anciano , Anciano de 80 o más Años , Antineoplásicos/efectos adversos , Enfermedades Cardiovasculares/inducido químicamente , Erupciones por Medicamentos/etiología , Resistencia a Antineoplásicos , Femenino , Enfermedades Gastrointestinales/inducido químicamente , Compuestos Heterocíclicos de 4 o más Anillos/efectos adversos , Humanos , Estimación de Kaplan-Meier , Leucemia Linfocítica Crónica de Células B/enzimología , Leucemia Linfocítica Crónica de Células B/mortalidad , Masculino , Persona de Mediana Edad , Piperidinas/efectos adversos , Piperidinas/uso terapéutico , Supervivencia sin Progresión , Inhibidores de Proteínas Quinasas/efectos adversosRESUMEN
Hydroxychloroquine and chloroquine, also known as antimalarial drugs, are widely used in the treatment of rheumatic diseases and have recently become the focus of attention because of the ongoing COVID-19 pandemic. Rheumatologists have been using antimalarials to manage patients with chronic immune-mediated inflammatory rheumatic diseases for decades. It is an appropriate time to review their immunomodulatory and anti-inflammatory mechanisms impact on disease activity and survival of systemic lupus erythematosus patient, including antiplatelet effect, metabolic and lipid benefits. We also discuss possible adverse effects, adding a practical and comprehensive approach to monitoring rheumatic patients during treatment with these drugs.
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Antimaláricos/farmacología , Artritis Reumatoide/tratamiento farmacológico , Cloroquina/farmacología , Hidroxicloroquina/farmacología , Lupus Eritematoso Sistémico/tratamiento farmacológico , Síndrome Antifosfolípido/tratamiento farmacológico , Síndrome Antifosfolípido/inmunología , Antirreumáticos/uso terapéutico , Artritis Reumatoide/inmunología , COVID-19 , Infecciones por Coronavirus/tratamiento farmacológico , Erupciones por Medicamentos/etiología , Interacciones Farmacológicas , Femenino , Glucosa/metabolismo , Cardiopatías/inducido químicamente , Humanos , Lípidos/sangre , Lupus Eritematoso Cutáneo/tratamiento farmacológico , Lupus Eritematoso Cutáneo/inmunología , Lupus Eritematoso Sistémico/inmunología , Lupus Eritematoso Sistémico/mortalidad , Masculino , Pandemias , Agregación Plaquetaria/efectos de los fármacos , Neumonía Viral/tratamiento farmacológico , Embarazo , Insuficiencia Renal/prevención & control , Enfermedades de la Retina/inducido químicamente , Síndrome de Sjögren/tratamiento farmacológico , Síndrome de Sjögren/inmunologíaAsunto(s)
Quimioexfoliación , Aceite de Crotón/efectos adversos , Composición de Medicamentos , Erupciones por Medicamentos/etiología , Emulsionantes/administración & dosificación , Fenol/efectos adversos , Animales , Aceite de Crotón/administración & dosificación , Erupciones por Medicamentos/patología , Fenol/administración & dosificación , PorcinosRESUMEN
The fixed drug eruption is a non-immediate hypersensitivity reaction to drug, characterized by recurrent erythematous or violaceous, rounded, well-defined border plaques, which always appear in the same location every time the culprit drug is administered. The usual practice is to avoid the drug involved and to use a structurally different drug. However, there are situations in which there is no safe and effective therapy. In such situations, desensitization is the only option. We describe the case of a patient who presented fixed eruption due to sulfamethoxazole-trimethoprim, who underwent successful desensitization, but required a repeat procedure twice due to relapse after inadvertent full-dose reintroduction. In non-immediate hypersensitivity reaction to drug, the indication is controversial and there is no technical standardization. Furthermore, the time at which such tolerance is lost after discontinuing the drug involved is unknown. In severe non-immediate reactions of types II and III, desensitization is contraindicated. The patient underwent desensitisation to sulfamethoxazole-trimethoprim three times - the first with recurrence of lesions and the second and third without manifestations, all concluded successfully and with no premedication.
Asunto(s)
Desensibilización Inmunológica/métodos , Erupciones por Medicamentos/tratamiento farmacológico , Erupciones por Medicamentos/etiología , Combinación Trimetoprim y Sulfametoxazol/efectos adversos , Anciano , Hipersensibilidad a las Drogas/tratamiento farmacológico , Hipersensibilidad a las Drogas/etiología , Humanos , Masculino , Sulfametoxazol/efectos adversos , Trimetoprim/efectos adversosRESUMEN
ABSTRACT The fixed drug eruption is a non-immediate hypersensitivity reaction to drug, characterized by recurrent erythematous or violaceous, rounded, well-defined border plaques, which always appear in the same location every time the culprit drug is administered. The usual practice is to avoid the drug involved and to use a structurally different drug. However, there are situations in which there is no safe and effective therapy. In such situations, desensitization is the only option. We describe the case of a patient who presented fixed eruption due to sulfamethoxazole-trimethoprim, who underwent successful desensitization, but required a repeat procedure twice due to relapse after inadvertent full-dose reintroduction. In non-immediate hypersensitivity reaction to drug, the indication is controversial and there is no technical standardization. Furthermore, the time at which such tolerance is lost after discontinuing the drug involved is unknown. In severe non-immediate reactions of types II and III, desensitization is contraindicated. The patient underwent desensitisation to sulfamethoxazole-trimethoprim three times − the first with recurrence of lesions and the second and third without manifestations, all concluded successfully and with no premedication.
RESUMO A erupção fixa por drogas é uma reação de hipersensibilidade a medicamento não imediata, caracterizada por placas eritematosas ou violáceas, arredondadas, recorrentes, de bordas bem definidas e que aparecem sempre na mesma localização cada vez que o medicamento culpado é administrado. A prática habitual é evitar a droga envolvida e utilizar um medicamento estruturalmente diferente. Contudo, há situações em que não há terapêutica segura e eficaz. Em tais situações, a dessensibilização é a única opção. Descrevemos o caso de um paciente que apresentou erupção fixa por drogas por sulfametoxazol-trimetoprim, tendo sido submetido à dessensibilização com sucesso, mas necessitou repetição do procedimento duas vezes, por recidiva da reação após reintrodução inadvertida em dose plena. Em reação de hipersensibilidade a medicamento não imediata, a indicação é controversa e não há padronização técnica. Além disso, não se conhece o tempo durante o qual essa tolerância é perdida após a suspensão da droga envolvida. Nas reações não imediatas graves e dos tipos II e III, a dessensibilização está contraindicada. O paciente foi submetido a dessensibilização ao sulfametoxazol-trimetoprim por três vezes − a primeira com recorrência de lesões, e a segunda e terceira sem manifestações, sendo todas concluídas com sucesso e sem uso de pré-medicação.
Asunto(s)
Humanos , Masculino , Anciano , Combinación Trimetoprim y Sulfametoxazol/efectos adversos , Desensibilización Inmunológica/métodos , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/tratamiento farmacológico , Sulfametoxazol/efectos adversos , Trimetoprim/efectos adversos , Hipersensibilidad a las Drogas/etiología , Hipersensibilidad a las Drogas/tratamiento farmacológicoRESUMEN
BACKGROUND: Reports regarding the causative drugs of drug-induced cutaneous adverse reactions in China are indistinct, such that different regions have reported the spectrum of drugs differs substantially in different clinical conditions. OBJECTIVE: To explore the causative drugs that led to cutaneous reactions. METHODS: Adverse drug reaction reports from central China were collected and divided into cutaneous adverse reactions and severe cutaneous adverse reactions groups. Cases were reviewed retrospectively for causative drugs. RESULTS: The male:female ratio was equal in both cutaneous adverse reactions and severe cutaneous adverse reactions. In cutaneous adverse reactions (n=482), the highest incidence happened between 51 and 60 years of age and the top three causative drugs were antibiotics (48%), Chinese medicine (16%), and allopurinol (9%). In severe cutaneous adverse reactions (n=126), the highest incidence happened between 41 and 50 years of age and the top three causative drugs were sedative-hypnotics and antiepileptics (39%), antibiotics (22%), and allopurinol (15%). Carbamazepine was the most frequently used single-drug (16/18) in sedative-hypnotics and antiepileptics. ß-lactams were the most frequently used antibiotics that induced both cutaneous adverse reactions and severe cutaneous adverse reactions. STUDY LIMITATIONS: The small sample size, retrospective design, collection of cutaneous adverse reactions and severe cutaneous adverse reactions at different time frames and locations, and exclusion of patients taking more than five medications are limitations of the study. CONCLUSIONS: Gender does not affect cutaneous adverse reactions and severe cutaneous adverse reactions. The top three drugs to induce cutaneous adverse reactions are antibiotics, Chinese medicine, and allopurinol, while those that triggered severe cutaneous adverse reactions are sedative-hypnotics and antiepileptics, antibiotics, and allopurinol. Carbamazepine is the most frequent single drug that induces severe cutaneous adverse reactions. ß-lactams are the most frequently used antibiotics that induce both cutaneous adverse reactions and severe cutaneous adverse reactions.
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Erupciones por Medicamentos/epidemiología , Erupciones por Medicamentos/etiología , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Antibacterianos/efectos adversos , Anticonvulsivantes/efectos adversos , Niño , Preescolar , China/epidemiología , Humanos , Hipnóticos y Sedantes/efectos adversos , Incidencia , Lactante , Persona de Mediana Edad , Estudios Retrospectivos , Distribución por Sexo , Adulto JovenRESUMEN
Abstract Background: Reports regarding the causative drugs of drug-induced cutaneous adverse reactions in China are indistinct, such that different regions have reported the spectrum of drugs differs substantially in different clinical conditions. Objective: To explore the causative drugs that led to cutaneous reactions. Methods: Adverse drug reaction reports from central China were collected and divided into cutaneous adverse reactions and severe cutaneous adverse reactions groups. Cases were reviewed retrospectively for causative drugs. Results: The male:female ratio was equal in both cutaneous adverse reactions and severe cutaneous adverse reactions. In cutaneous adverse reactions (n = 482), the highest incidence happened between 51 and 60 years of age and the top three causative drugs were antibiotics (48%), Chinese medicine (16%), and allopurinol (9%). In severe cutaneous adverse reactions (n = 126), the highest incidence happened between 41 and 50 years of age and the top three causative drugs were sedative-hypnotics and antiepileptics (39%), antibiotics (22%), and allopurinol (15%). Carbamazepine was the most frequently used single-drug (16/18) in sedative-hypnotics and antiepileptics. β-lactams were the most frequently used antibiotics that induced both cutaneous adverse reactions and severe cutaneous adverse reactions. Study limitations: The small sample size, retrospective design, collection of cutaneous adverse reactions and severe cutaneous adverse reactions at different time frames and locations, and exclusion of patients taking more than five medications are limitations of the study. Conclusions: Gender does not affect cutaneous adverse reactions and severe cutaneous adverse reactions. The top three drugs to induce cutaneous adverse reactions are antibiotics, Chinese medicine, and allopurinol, while those that triggered severe cutaneous adverse reactions are sedative-hypnotics and antiepileptics, antibiotics, and allopurinol. Carbamazepine is the most frequent single drug that induces severe cutaneous adverse reactions. β-lactams are the most frequently used antibiotics that induce both cutaneous adverse reactions and severe cutaneous adverse reactions.
Asunto(s)
Humanos , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/epidemiología , China/epidemiología , Incidencia , Estudios Retrospectivos , Factores de Edad , Distribución por Sexo , Distribución por Edad , Hipnóticos y Sedantes/efectos adversos , Antibacterianos/efectos adversos , Anticonvulsivantes/efectos adversosRESUMEN
Capecitabine is a prodrug used primarily as a chemotherapeutic agent. Despite its good tolerance, it has several adverse effects, including the appearance of eruptive nevi. We present the case of a patient, with a history of EC IV breast adenocarcinoma and superficial extension melanoma, which developed 2 weeks after the start of therapy with capecitabine multiple eruptive palmoplantar pigmented lesions, with diverse benign dermatoscopic patterns. With the increasing incidence of solid tumors, these agents are being more used. It is important that the treating physician knows its adverse effects and apply non-invasive diagnostic tools like dermoscopy to avoid unnecessary biopsies.
La capecitabina es un profármaco utilizado sobre todo como medicamento quimioterapéutico. A pesar de su buena tolerancia, produce diversos efectos adversos como la aparición de nevos eruptivos. Se presenta el caso de una paciente, con antecedentes de adenocarcinoma de mama (EC IV) y melanoma de extensión superficial, que desarrolló dos semanas posteriores al inicio del tratamiento con capecitabina múltiples lesiones eruptivas pigmentadas palmoplantares, con patrones variados benignos a la dermatoscopia. Con el incremento de las neoplasias sólidas, estos agentes se utilizan cada vez más. Es importante que el médico tratante conozca sus efectos adversos y aplique herramientas diagnósticas no invasivas como la dermatoscopia para evitar biopsias innecesarias.
Asunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Capecitabina/efectos adversos , Dermoscopía , Erupciones por Medicamentos/diagnóstico por imagen , Dermatosis del Pie/inducido químicamente , Dermatosis de la Mano/inducido químicamente , Adenocarcinoma , Antimetabolitos Antineoplásicos/uso terapéutico , Neoplasias de la Mama , Capecitabina/uso terapéutico , Diagnóstico Diferencial , Erupciones por Medicamentos/etiología , Femenino , Dermatosis del Pie/diagnóstico por imagen , Dermatosis de la Mano/diagnóstico por imagen , Humanos , Melanoma/diagnóstico , Melanoma/tratamiento farmacológico , Persona de Mediana Edad , Neoplasias Primarias Secundarias/tratamiento farmacológico , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/tratamiento farmacológicoRESUMEN
BACKGROUND: Furosemide is the most commonly prescribed loop diuretic worldwide. Although, its extended use, furosemide rarely induces allergic reactions. Until 2013, only 49 cases of furosemide allergy had been described. CLINICAL CASE: We have reported on a patient who developed a delayed, erythematous and pruritic skin eruption after the ingestion of furosemide. The implication of furosemide in the reaction was established by a positive lymphocyte transformation test (LTT). CONCLUSION: This is the first reported case of hypersensitivity to furosemide in which this drug was confirmed as the trigger by a positive LTT. LTT could become a decent diagnostic alternative for patients who experience delayed reactions to furosemide.
Antecedentes: La furosemida es el diurético de asa más comúnmente prescrito en todo el mundo. A pesar de su amplio uso, rara vez induce reacciones alérgicas. Hasta 2013 solo se habían descrito 49 casos de alergia a la furosemida. Caso clínico: Mujer de 68 años con hipertensión tratada con amlodipina, así como rinoconjuntivitis alérgica. Después del consumo de 40 mg de furosemida por cinco días debido a edema bilateral maleolar presentó exantema cutáneo maculopapular, eritematoso y pruriginoso. Los resultados positivos en la prueba de transformación de linfocitos confirmaron la implicación de la furosemida en la reacción. Conclusión: El caso que se reporta es el primero de hipersensibilidad a la furosemida en el que se confirma la implicación del fármaco por medio de una prueba de transformación de linfocitos positiva, la cual podría convertirse en una alternativa diagnóstica para los pacientes que experimentan reacciones adversas tardías a la furosemida.
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Diuréticos/efectos adversos , Erupciones por Medicamentos/etiología , Furosemida/efectos adversos , Hipersensibilidad Tardía/etiología , Activación de Linfocitos/efectos de los fármacos , Anciano , Diuréticos/farmacología , Femenino , Furosemida/farmacología , HumanosRESUMEN
Drug-induced liver injury (DILI) is the leading cause of acute liver failure (ALF) in developed countries. The extremely variable phenotype of DILI, both in presentation and in severity, is one of the distinctive characteristics of the disease and one of the major challenges that hepatologists face when assessing hepatotoxicity cases. A new Hy's law that more accurately predicts the risk of ALF related to DILI has been proposed and validated. Other prognostic scoring algorithms for the early identification of DILI patients who may go on to develop ALF have been developed as it is of most clinical relevance to stratify patients for closer monitoring. Recent data indicate that acute DILI often presents a more prolonged resolution or evolves into chronicity at a higher frequency than other forms of acute liver injury. Risk factors for chronicity, specific phenotypes, and histological features are discussed in this study. Biomarkers to predict DILI outcome are in need.