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[Oxcarbazepine and DRESS syndrome: a paediatric cause of acute liver failure]
[Article in French]
Bosdure E, Cano A, Roquelaure B, Reynaud R, Boyer M, Viard L, Sarles J.
Service de pediatrie multidisciplinaire, hopital Timone-enfant, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, also called hypersensitivity reaction, is a severe idiosyncratic reaction to drugs, especially to anti-epileptic drugs. Clinical features associate cutaneous eruption, fever, multiple peripheral ganglions, and potentially life-threatening damage of one or more organs. DRESS syndrome is well described in adults treated with aromatic anti-epileptic drugs, such as phenytoin, phenobarbital, and carbamazepine, but also with other drugs. The new anti-epileptic drugs, such as oxcarbazepine also induce various cutaneous eruptions, but with less report of DRESS syndrome. In children, DRESS syndrome is rare and probably underdiagnosed. We report on the case of a 11-year-old girl hospitalised with an acute severe hepatitis revealing an oxcarbazepine-induced DRESS syndrome.
Publication Types:
PMID: 15350998 [PubMed - indexed for MEDLINE]
Interleukin-2-associated bullous drug dermatosis.
Hofmann M, Audring H, Sterry W, Trefzer U.
Publication Types:
PMID: 15604553 [PubMed - indexed for MEDLINE]
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Fatal colchicine poisoning by accidental ingestion of meadow saffron-case report.
Sundov Z, Nincevic Z, Definis-Gojanovic M, Glavina-Durdov M, Jukic I, Hulina N, Tonkic A.
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Clinical Hospital Split, Spinciceva 1, 21000 Split, Croatia.
A 62-year-old male died of colchicine poisoning after accidental ingestion of Colchicum autumnale (meadow saffron). He ate a salad of plant with green leaves regarded as wild garlic (Allium ursinum). A few hours later he developed symptoms of gastroenteritis and was admitted to hospital. In spite of gastric lavage, activated charcoal and supportive measures, multi-organ system failure developed over the next two days. Laboratory analysis showed highly elevated blood concentrations of hepatic enzymes, creatine kinase, lactate dehydrogenase and blood urea nitrogen, as well as leukocytopenia and thrombocytopenia. Mechanical ventilation, dopamine, noradrenaline, crystalloid solutions and fresh frozen plasma were applied but despite treatment the patient died five days after the ingestion. Post-mortem examination revealed hepatic centrilobular necrosis, nephrotoxic acute tubular necrosis, petechial bleeding in fatty tissue, blunt and shortened intestinal villi and cerebral toxic edema. Botanical identification of incriminated plant gave Colchicum autumnale which confirmed colchicine poisoning. Although the accidental ingestion of Colchicum autumnale is rare and to our knowledge only five such cases have been described in detail, this is the second fatal case in Croatia described in the last 3 years.
PMID: 15749368 [PubMed - in process]
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A fatal poisoning caused by methomyl and nicotine.
Moriya F, Hashimoto Y.
Department of Legal Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.
A 35-year-old male was found lying in a prone position in his room. He was in cardiopulmonary arrest on arrival to hospital and was pronounced dead. There was no attempt at resuscitation. No miosis was observed on admission. At post-mortem his stomach contained 170g greenish liquid with a small amount of shredded tobacco leaves. The serum cholinesterase activities were 47-90 IU (normal range for male: 200-440 IU). GC and GC-MS analyses showed nicotine (21.8mg), methomyl (304mg), and triazolam (1.69mg) in his stomach. He had consumed tobacco leaves, Lannatetrade mark containing water soluble methomyl (45%), and Halciontrade mark tablets containing 0.25mg triazolam. Methomyl concentrations in blood were 3-8ng/ml. Substantial amounts of methomyl (2260-2680ng/ml) were detected in cerebrospinal fluid and vitreous humor. Nicotine concentrations in blood ranged from 222 to 733ng/ml. A small amount of triazolam was detected only in bile (176ng/ml) and liver (23ng/g). The cause of death was respiratory paralysis produced by the additive effects of methomyl and nicotine shortly after consumption.
PMID: 15749358 [PubMed - in process]
Lead poisoning associated with use of litargirio--Rhode Island, 2003.
Centers for Disease Control and Prevention (CDC).
Lead can damage the neurologic, hematologic, and renal systems. Deteriorated leaded paint in older housing remains the most common source of lead exposure for children in the United States; however, other lead sources increasingly are recognized, particularly among certain racial/ethnic populations. In 2003, the Rhode Island Department of Health (RIDOH) recognized litargirio (also known as litharge or lead monoxide), a yellow or peach-colored powder used as an antiperspirant/deodorant and a folk remedy in the Hispanic community, as a potential source of lead exposure for Hispanic children. This report summarizes a case investigation of elevated blood lead levels (BLLs > or =10 microg/dL) associated with litargirio use among two siblings in Rhode Island, the public health action taken, and a survey of parents/guardians in three pediatric clinics in Providence, Rhode Island, to assess litargirio use. Findings underscore the importance of follow-up of elevated BLLs and thorough investigation to identify all lead sources.
Publication Types:
PMID: 15758896 [PubMed - indexed for MEDLINE]
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