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The possible underlying neurotransmitter mechanisms, predisposing factors and clinical implications of this rare adverse event are discussed.
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In rare cases mitomycin C (MMC) may induce cancer-associated hemolytic uremic syndrome, which is characterized by hemolytic anemia, thrombocytopenia and progressive renal failure.
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Obese patients represent a unique group of patients in which TDM is extremely valuable in optimizing dosing, particularly in high-dose chemotherapy.
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CONCLUSION: This case illustrates a potential link between dermatologic and ocular 5-FU toxicities.
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Integrating drug history, clinical morphology, clinical distribution, and histopathology can aid in the differentiation.
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A retrospective epidemiological study of deaths from hepatic angiosarcoma (HAS) in the U.S. showed that during 1964--74 there were 168 such cases, of which 37 (22%) were associated with previously known causes (vinyl chloride, 'Thorotrast', and inorganic arsenic) and 4 (3.1%) of the remaining 131 cases with the use of androgenic-anabolic steroids.
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It must be considered as a potential source of cerebral hemorrhage in elderly patients undergoing thrombolysis for cardiac ischemia.
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A 58-year-old woman with rheumatoid arthritis (RA) developed fever, skin eruptions, leukocytopenia, and thrombocytopenia, 3 weeks after treatment with sulfasalazine.
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There are, however, well-known systemic side effects that may preclude continuation with these immunosuppressive therapies, and small trials of the anti-metabolite mycophenolate mofetil have been reported.
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Coagulase-positive Staphylococcus aureus was cultured in the aspirate.
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Discussion covers conjunctival carcinoma and behaviour of HIV-related tumours with antiretroviral therapy.
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In this report, we describe a fatal gemcitabine-induced pulmonary toxicity in a patient with gallbladder metastatic adenocarcinoma.
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Both were treated successfully with oral potassium.
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Rifampin can be associated with severe adverse effects such as hepatitis, acute renal failure, hemolytic anemia, and thrombocytopenia.
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PURPOSE: Eosinophilic jejunitis is a rare disorder of undetermined origin, which is characterized by infiltration of eosinophils in the intestine.
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After 1 month of treatment, he was diagnosed as having acute renal failure secondary to HUS.
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Both patients received prolonged treatment with high doses of intravenous methylprednisolone.
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One patient was an 80-year-old woman who was admitted for Staphylococcus aureus knee arthritis after several intraarticular injections of sodium hyaluronate and corticosteroids.
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A 15 Year old female patient with Sturge Weber Syndrome is presented.
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If the facial scar is a cosmetic problem 1 year after the injury, triamcinolone injections and local massage should be considered.
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RESULTS: Acanthamoeba keratitis was diagnosed in six eyes with a previous misdiagnosis of Herpes simplex keratitis in two patients and a misdiagnosis of corneal graft rejection in the third patient.
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The itch spread to the arms, abdomen and legs and the patient treated himself with clemastine and the itch disappeared.
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These findings suggest that elevated intraocular pressure can contribute to interface inflammation.
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A 79-year-old man with ischemic heart disease, chronic atrial fibrillation, chronic renal failure, hypothyroidism, and gout arthritis was hospitalized because of fatigue, myalgia, and leg weakness, shortly after starting treatment with colchicine.
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DESIGN: Interventional case report.
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He noticed nausea and headache and serum Na fell as low as 118 mEq/l.
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Caution in longterm usage and early recognition of pentazocine toxicity as a neuromuscular complication are important in order to prevent irreversible drug-induced fibrous myopathy and localized neuropathy.
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A case of Kluver-Bucy syndrome associated with delayed cerebral necrosis after radiation therapy and chemotherapy is reported.
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In our patient, histology showed aspects of drug-induced skin reaction without vasculitis.
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A second challenge while the patient received all fluids and electrolytes intravenously again resulted in decreased serum sodium concentration (134 to 126 mEq/L) after urinary loss of only 69 mEq of cation.
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We thus concluded that an excessive dose of AZ had probably destroyed the gastric mucosal barrier or thrombocytopenia due to bone marrow disorder and thus eventually led to the development of hemorrhagic gastritis.
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Transient central diabetes insipidus in the setting of underlying chronic nephrogenic diabetes insipidus associated with lithium use.
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However, our patient was later found to have re-activation tuberculosis after long-term treatment.
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Unusual pigmentary changes associated with 5-fluorouracil therapy.
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Heat stroke-like episode in a child caused by zonisamide.
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We believe this is the first report of intrathecal diamorphine causing anaphylaxis.
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This case demonstrates the importance of blood flow from the peribiliary arteries for the survival of the biliary epithelium.
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The diagnosis was confirmed by liver biopsy, antimitochondrial antibody, muscle biopsy, and electromyography.
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PURPOSE: Differential diagnosis of maculopathies can be difficult but is important if patients also suffer from other diseases such as breast cancer treated with antiestrogens.
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About 30% of patients have an initial remission on steroids alone, but most require some form of cytotoxic chemotherapy.
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In the presence of left ventricular hypertrophy, the positive inotropic action of catecholamines with mainly beta-receptor specificity can lead to excessive hypercontractility and paradoxical hypotension.
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This report describes a case of paradoxical, intravenous valproic acid-induced seizure exacerbation in a child with juvenile absence epilepsy, documented by video-electroencephalography.
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Doctors involved in the use of indwelling intrathecal catheters for pain control must be aware of the risk of significant neurological sequelae but should not dismiss re-establishment of intrathecal therapy in the presence of significant neurological complications.
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After cessation of treatment there was a gradual resolution with regain of normal nails after 7 months.
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Myocardial infarction (MI), associated with the use of these concentrates, is a well-recognized, but uncommon, complication.
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An association of granulocytopenia, eosinophilia, skin reaction and hepatitis during propylthiouracil (PTU) therapy for thyrotoxicosis in a 47 year old black female is reported.
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One case presented with Stevens-Johnson syndrome, and the other had systemic papular erythema.
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Clinical and chemical improvement was observed in the majority of subjects but normal 24-hour serum growth hormone levels were achieved in no more than 35 percent of this group and possibly less.
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This translocation determines a fusion gene, bcr-abl, which encodes a constitutively active protein, tyrosine kinase, resulting in decreased apoptosis, defective adhesion, and genomic instability in transformed cells.
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The patient had on the medial aspect of the thigh a fixed solitary, recurrent, indurated, erythematous plaque, which resolved within 2 days.
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Hypoglycaemic brittle diabetes successfully managed by social worker intervention.
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OBJECTIVE: To investigate the mechanisms involved in hypersensitivity reactions to cyclosporine and determine the feasibility of future cyclosporine use.
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Anaphylactoid shock, disseminated intravascular coagulation, and anuric renal failure requiring dialysis occurred in a patient receiving zomepirac sodium for toothache.
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Retinal abnormalities, including retinal hemorrhage and "cotton-wool" spots, often occur within the first 8 weeks in the course of interferon therapy in patients with chronic hepatitis C.
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Coronary thrombolysis with streptokinase or tissue plasminogen activator is useful for the treatment of acute myocardial infarction in selected patients.
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Inflammatory reactions in progressive multifocal leukoencephalopathy after highly active antiretroviral therapy.
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We discuss a patient who developed severe renal tubular dysfunction secondary to short-term therapy with Amikacin, resulting in refractory hypokalemia, hypocalcemia, hypomagnesemia, metabolic alkalosis, and polyuria.
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A case is reported in which severe hypocalcemia, with a low plasma parathyroid hormone (PTH) concentration, resulted from the therapeutic use of magnesium sulfate for toxemia of pregnancy.
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To our knowledge, the syndrome of fever, pulmonary infiltrates, and pleural effusion following use of acyclovir has not been previously reported.
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Treatment with tacrolimus ointment completely resolved the oral lesions after 2 months of therapy.
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Gemcitabine-induced pericardial effusion and tamponade after unblocked cardiac irradiation.
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Metoclopramide hydrochloride (Reglan) is a widely prescribed drug for treatment of upper gastrointestinal symptoms.
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The first is a case of disseminated candidiasis with stomach wall involvement.
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After having been on interferon therapy for three years, she developed skin lesions secondary to scleromyxedema.
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Hydrofluoric acid burns.
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The elimination half-life of both drugs is 0.5-0.7 hours.
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Combination antimalarial therapy is being explored to delay development of resistance to falciparum malaria.
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The acute reaction to nitrofurantoin is believed to be mediated by an immune mechanism.
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She was found to have hyperventilation and weakness of four limbs, with muscle power of grade 5(-)/5.
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Control hysterosalpingograms showed no tubal patency on the involved side.
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BACKGROUND: reports on delated cutaneous reactions to captopril have been seldom reported.
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A cutaneous biopsy for histologic analysis was performed.
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She died within six weeks of developing congestive heart failure coupled with liver failure due to haemosiderosis despite regular use of desferrioxamine.
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Ibopamine-induced reversible leukopenia during treatment for congestive heart failure.
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Perhaps for this reason, the teeth and craniofacial features of patients with leprechaunism have never been reported.
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Among the various clinical and pathological manifestations of hydrocarbon (HC) poisoning, pneumonitis is the most significant and occurs in up to 40% of children, whereas formation of pneumatoceles is believed to be a rare event.
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Later, he had no impulse disorders (no gambling, hypersexuality, excessive shopping), which occur with dopamine agonists, suggesting that levodopa abuse and impulse disorders can result through different mechanisms.
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The patient was ultimately discharged to home.
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Bone marrow biopsy showed a moderately hypocellular marrow; 51% of the nucleated cells were blasts with myelomonocytic differentiation.
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Stroke is an infrequent but recognized complication of heroin addiction.
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The temporal relationship suggests that the spinal cord infarction may be related to the use of zolmitriptan.
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The patient had no skin reactions for the next 12 mo, with the exception of injection-site papules.
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These findings suggest that bicytopenia in this patient was caused by D-Pen and may be due to different sensitivities in the hematopoietic lineage.
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She was treated with an intra-articular injection of 80 mg methylprednisolone into her sacroiliac joint, followed 2 days later by a cluster of herpetiform vesicles adjacent to the injection site.
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METHODS: Repeated blood samples were drawn in a patient with severe acyclovir overdose who developed coma and nonoliguric renal failure.
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She had been receiving oral furosemide for 5 months at the time of this report, with no complications.
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We report for the first time the development of symptomatic methemoglobinemia after an acute ingestion of divalproex sodium (Depakote), resulting in serum concentrations 10 times greater than the therapeutic range.
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We report a case of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) secondary to trimethoprim-sulfamethoxazole (TMP-Sx) therapy for presumed community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection.
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Discontinuing the oxybutynin leads to complete neurological recovery associated with normalisation of her blood pressure.
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Fever continued postoperatively until therapy with posaconazole was initiated.
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RESULTS: There were several systemic complications including coagulopathy, hypocalcemia and pancreatitis.
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Teriparatide is a promising treatment for patients who have failed bisphosphonate treatment or who are at high risk for fracture.
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Cholesterol crystal embolization-associated renal failure after therapy with recombinant tissue-type plasminogen activator.
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Over the next 4 months, there was progressive corneal stromal thinning and descemetocele formation in 1 eye, requiring application of cyanoacrylate glue, and stromal edema and scarring in the other eye, which resulted in a visual acuity of counting fingers.
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After 36 h the hyponatremic episode improved after the infusion of hypertonic sodium chloride.
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This report emphasizes the unnecessary hazard accompanying use of a potentially toxic drug-especially when prepared in error by the pharmacist-when a safer drug (nystatin) is available for treatment of oral candidiasis.
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The drug has few side effects but some patients have developed clinical features of Cushing's syndrome.
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In chronic hepatitis B viral infection TNF-alpha is readily produced, and viral clearance is dependent on the amount bioavailable.
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His clinical features included erythematous, edematous plaques and peripheral neuropathy.
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There are interesting effects of this drug in HIV-positive diabetic patients.
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