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Delayed absorption and postdialysis rebound in a case of acute methanol poisoning.
Elwell RJ, Darouian P, Bailie GR, Eisele G, McGoldrick MD.
PMID: 15011234 [PubMed - in process]
Metformin hepatotoxicity.
Deutsch M, Kountouras D, Dourakis SP.
Publication Types:
PMID: 14996697 [PubMed - indexed for MEDLINE]
Kinetics and specificity of fas ligand induction in toxic epidermal necrolysis.
Chang HY, Cooper ZA, Swetter SM, Marinkovich MP.
Publication Types:
PMID: 14967808 [PubMed - indexed for MEDLINE]
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Severe, generalized nummular eczema secondary to interferon alfa-2b plus ribavirin combination therapy in a patient with chronic hepatitis C virus infection.
Moore MM, Elpern DJ, Carter DJ.
Harvard Medical School, Boston, Massachusetts, USA.
BACKGROUND: With increasing rates of hepatitis C virus infection and diagnosis, more patients are being treated with interferon alfa-2b plus ribavirin therapy. Cutaneous side effects to combination therapy are common and may limit treatment. There are few previous case reports of generalized eczematous dermatoses occurring after combination therapy for hepatitis C virus, none in a North American patient, and none of this severity or recalcitrance. OBSERVATIONS: A man with chronic hepatitis C virus infection and no history of atopy developed severe, recalcitrant nummular eczema secondary to interferon alfa-2b plus ribavirin combination therapy. The cutaneous side effect was more severe than in previously reported cases and did not remit on discontinuation of therapy. CONCLUSIONS: Greater awareness of the range of dermatologic responses to interferon alfa-2b plus ribavirin therapy may lead to improved surveillance for and treatment of these side effects. Investigating the underlying pathologic mechanisms may ultimately allow for a greater understanding of the immunomodulatory effects of this therapy in the setting of chronic hepatitis C virus infection.
Publication Types:
PMID: 14967798 [PubMed - indexed for MEDLINE]
Comment in:
Association between anticonvulsant hypersensitivity syndrome and human herpesvirus 6 reactivation and hypogammaglobulinemia.
Kano Y, Inaoka M, Shiohara T.
Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan.
BACKGROUND: Anticonvulsant hypersensitivity syndrome (AHS) is a life-threatening, drug-induced, multiorgan system reaction. The identification of predisposing factors is clearly needed to predict the incidence and outcome of AHS; attention has recently been focused on reactivation of human herpesvirus 6 (HHV-6). OBJECTIVE: To determine whether immunosuppressive conditions that can allow HHV-6 reactivation could be specifically detected in association with the onset of AHS. DESIGN: We analyzed patients with AHS who were treated during 1997-2002. Two groups of patients receiving anticonvulsants served as controls. SETTING: Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan.Patients Ten patients with AHS. MAIN OUTCOME MEASURES: The results of serologic tests for antibody titers for various viruses, including HHV-6, HHV-6 DNA detection by real-time polymerase chain reaction, immunoglobulin levels by turbidimetric immunoassay, IgG subclass levels by nephelometry, and CD19(+) B-cell counts by flow cytometric analysis, were sequentially assessed. RESULTS: Serum IgG levels (mean, 745 mg/dL) and circulating B-cell counts (mean, 88/ micro L) in patients with AHS were significantly decreased at onset compared with control groups (P<.001 and P =.007, respectively). These alterations returned to normal on full recovery. Reactivation of HHV-6 as judged by a greater than 4-fold increase in HHV-6 IgG titers was exclusively detected in most patients with AHS associated with decreased IgG levels and B-cell counts. CONCLUSIONS: A decrease in immunoglobulin levels and B-cell counts can be associated with HHV-6 reactivation and the subsequent onset of AHS. These immunological alterations might be a useful predictor of the development of AHS.
PMID: 14967790 [PubMed - indexed for MEDLINE]
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A semisynthetic bilaminar skin substitute used to treat pediatric full-body toxic epidermal necrolysis: wraparound technique in a 17-month-old girl.
Bannasch H, Kontny U, Kruger M, Stark GB, Niemeyer CM, Brandis M, Horch RE.
Freiburg University Medical School, Freiburg, Germany.
Publication Types:
PMID: 14967786 [PubMed - indexed for MEDLINE]
Extensive fixed drug eruption due to the Japanese herbal drug "kakkon-to".
Fujimoto N, Tajima S.
Publication Types:
PMID: 14674921 [PubMed - indexed for MEDLINE]
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Death following acute poisoning by moclobemide.
Giroud C, Horisberger B, Eap C, Augsburger M, Menetrey A, Baumann P, Mangin P.
Laboratoire de Toxicologie et de Chimie Forensiques, Institut Universitaire de Medecine Legale, rue du Bugnon 21, CH-1005 Lausanne, Switzerland. christian.giroud@hospvd.ch
A fatality due to ingestion of a reversible inhibitor of monoamine-oxidase A (MAO-A) is reported. Moclobemide is generally considered as a safe drug far less toxic than tricyclic anti-depressants. However, severe intoxications may result from interactions with other drugs and food such as selective serotonin reuptake inhibitors (SSRIs), anti-Parkinsonians of the MAOI-type (e.g. selegiline) or tyramine from ripe cheese or other sources. In the present case, high levels of moclobemide were measured in peripheral blood exceeding toxic values reported so far in the scientific literature. The body fluid concentrations of moclobemide were of 498 mg/l in peripheral whole blood, 96.3 mg/l in urine while an amount of approximately 33 g could be recovered from gastric contents. The other xenobiotics were considered of little toxicological relevance. The victim (male, 48-year-old) had a past history of depression and committed one suicide attempt 2 years before death. Autopsy revealed no evidence of significant natural disease or injury. It was concluded that the manner of death was suicide and that the unique cause of death was massive ingestion of moclobemide.
PMID: 15013171 [PubMed - in process]
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