High Procalcitonin in a Patient with Drug Hypersensitivity Syndrome

Bonaci-Nikolic, Branka; Jeremić, Ivica; Nikolić, Miloš; Andrejević, Sladjana; Lavadinović, Lidija

doi:10.2169/internalmedicine.48.2151

Cited by 16 publications

(12 citation statements)

References 14 publications

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“…In fact, some reports have described HHV-6 reactivation after drug administration inducing marked pleural effusion, ascites and hyponatremia (15)(16)(17). The elevation of procalcitonin levels has likewise been described in patients with drug reactions with eosinophilia and systemic symptoms (DRESS) and has been considered similar to DIHS (18).…”

Section: Discussionmentioning

confidence: 93%

Drug-induced Liver Injury with HHV-6 Reactivation

et al. 2015

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Liver dysfunction was identified in a 16-year-old boy hospitalized with high fever and abdominal pain and fullness. He had received pharmacotherapy for a headache 2 months previously and other drugs for a high fever 4 days prior to being admitted to our hospital. The patient's liver dysfunction was consistent with and fulfilled the criteria for drug induced liver injury, but the laboratory findings showed elevated procalcitonin levels, hyponatremia and leukocytosis. Moreover, we confirmed the presence of human herpesvirus 6 (HHV-6) DNA. The patient exhibited symptoms of high fever and abdominal pain and fullness but no exanthema. The clinical and laboratory findings did not satisfy the criteria for drug-induced hypersensitivity syndrome, and we speculate that the diversity of clinical and laboratory findings may have resulted from HHV-6 reactivation. To the best of our knowledge, this is the first case report on drug-induced liver injury with various findings due to HHV-6 reactivation. HHV-6 reactivation should be considered in patients with drug induced liver injury even in the absence of exanthema.

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Section: Discussionmentioning

confidence: 93%

Drug-induced Liver Injury with HHV-6 Reactivation

et al. 2015

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“…Thus it can be speculated that mycophenolate metabolite-mediated IL-6 production induces elevated PCT serum levels in the acute inflammatory syndrome. Interestingly, increased PCT serum levels have also been described recently in patients with idiosyncratic inflammatory drug reactions to azathioprine and carbamazepine, and in the neuroleptic malignant syndrome 7,8,9 . Therefore, drug reactions should be considered in the differential diagnosis of inflammatory states with elevated PCT in rheumatic diseases.…”

Section: Rheumatologymentioning

confidence: 90%

Acute Inflammatory Syndrome with Elevated Procalcitonin Induced by Mycophenolate Sodium: Figure 1.

Loock¹,

Lamprecht²,

Gross³

2012

J Rheumatol

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“…Procalcitonin (PCT), a propeptide of calcitonin, is an important host response biomarker indicating infection and its prognosis [6]. It may also increase in other clinical situations such as trauma, pancreatitis, cardiogenic shock, and drug hypersensitivity syndrome [7,8]. …”

Section: Introductionmentioning

confidence: 99%

25-OH-Vitamin D and procalcitonin levels after correction of acute hyperglycemia

et al. 2013

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BackgroundHyperglycemia is a common complication of diabetes melitis (DM) and in the absence of metabolic decompensation is a common finding in the Emergency Department (ED). We aimed to evaluate the 25 OH Vit D [25(OH)D] and procalcitonin (PCT) levels during hyperglycemia and after normalization of blood glucose.Material/MethodsThe study included 88 patients over the age of 18 years who presented with acute hyperglycemia at the Hacettepe University Department of Emergency Medicine. Euglycemia was obtained within 6–12 hours and serum samples were taken from patients on admission and 6 hours after normalization of blood glucose. Along with plasma glucose, plasma 25(OH)D and PCT levels were measured using ELISA.ResultsThere were 88 (45 males) patients, with a median age of 60.0±13.9 years. Serum 25(OH)D levels increased in all patients after normalization of blood glucose, and serum PCT levels decreased in the whole group. This decrease was independent of type of diabetes or presence of infection.ConclusionsWe demonstrated an increase in 25(OH)D after normalization of blood glucose, and a decrease in PCT in patients with hyperglycemia. This effect was independent of the type of diabetes and presence of infection. Further studies are needed to evaluate the faster link between metabolic abnormalities, vitamin D, PCT, and inflammation.

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High Procalcitonin in a Patient with Drug Hypersensitivity Syndrome

Abstract: We present a patient who developed carbamazepine (CBZ)

Cited by 16 publications

References 14 publications

Drug-induced Liver Injury with HHV-6 Reactivation

Drug-induced Liver Injury with HHV-6 Reactivation

Acute Inflammatory Syndrome with Elevated Procalcitonin Induced by Mycophenolate Sodium: Figure 1.

25-OH-Vitamin D and procalcitonin levels after correction of acute hyperglycemia

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