Propylthiouracil‐induced DRESS syndrome confirmed by a positive patch test

Ye, Y.-M.; Kim, J.-E.; Kim, J.-H.; Choi, Gyu-Dong; Park, Hae‐Sim

doi:10.1111/j.1398-9995.2009.02183.x

Cited by 13 publications

(8 citation statements)

References 6 publications

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“…There are also some reports of positive drug PTs in patients with DRESS 2 in response to abacavir, 18 antituberculous agents, 19 aspirin, 20 carbamazepine, 17,21 cyclins, beta‐lactam antibiotics, 9,22 celecoxib, 19 esomeprazole, 22 fluindione, 23 lamotrigine, 2 phenytoin, 3 propylthiouracil, 24 spironolactone and topiramate 3 …”

Section: Discussionmentioning

confidence: 99%

A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions

Barbaud

Collet

Milpied

et al. 2013

British Journal of Dermatology

333

272

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SummaryBackground Drug patch tests (PTs) can reproduce delayed hypersensitivity to drugs and entail a moderate re-exposure of patients to offending drugs. Objectives To determine the value of PTs for identifying the responsible drug in severe cutaneous adverse drug reactions (SCARs) such as acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS) and Stevens-Johnson syndrome ⁄toxic epidermal necrolysis (SJS ⁄TEN). Methods In a multicentre study, PTs were conducted on patients referred for DRESS, AGEP or SJS ⁄TEN within 1 year of their SCAR. All drugs administered in the 2 months prior to and the week following the onset of the SCAR were tested. Results Among the 134 patients included (48 male, 86 female; mean age 51AE7 years), positive drug PTs were obtained for 24 different drugs. These included positive tests for 64% (46 ⁄72) of patients with DRESS, 58% (26 ⁄45) of those with AGEP and 24% (4 ⁄17) of those with SJS ⁄TEN, with only one relapse of AGEP. The value of PTs depended on the type of drug and the type of SCAR (e.g. carbamazepine was positive in 11 ⁄13 DRESS cases but none of the five SJS ⁄TEN cases). PTs were frequently positive for beta lactams (22 cases), pristinamycin (11 cases) and in DRESS with pump proton inhibitors (five cases), but were usually negative for allopurinol and salazopyrin. Of 18 patients with DRESS, eight had virus reactivation and positive PTs. In DRESS, multiple drug reactivity was frequent (18% of cases), with patients remaining sensitized many years later. Conclusions PTs are useful and safe for identifying agents inducing SCAR.

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Section: Discussionmentioning

confidence: 99%

A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions

Barbaud

Collet

Milpied

et al. 2013

British Journal of Dermatology

333

272

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“…[6] Besides, other drugs of thionamides class such as carbimazole or propylthiouracil have been reported to induce DRESS syndrome. [78] This case presented here is, to our knowledge, the first case of DRESS following treatment with thyrozol in the Chinese population.…”

Section: Discussionmentioning

confidence: 89%

Drug reaction with eosinophilia and systemic symptom in a patient with pneumonia and hyperthyroidism

Jin¹,

Wang²,

Ye³

2017

J Res Pharm Pract

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Drug rash with eosinophilia and systemic symptoms syndrome is an idiosyncratic drug reaction characterized by fever, skin eruption, lymph node enlargement, and internal organ involvement. We report a case of a patient with pneumonia who developed clinical manifestations of fever, rash, lymphadenopathy, hypereosinophilia, and visceral involvement (renal failure and eosinophilic pneumonitis) caused by methimazole. The patient improved remarkably with drug withdrawal. A high index of clinical suspicion is emphasized to facilitate prompt diagnosis of medication-related adverse effect and its discontinuation.

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“…Do ponto de vista cutâneo, estes variam desde efeitos pouco significativos (apesar de geralmente conduzirem à suspensão do fármaco), tais como urticária ou exantema morbiliforme, até efeitos mais graves, dos quais se salienta a síndrome de hipersensibilidade e sobretudo a vasculite leucocitoclásica, com ou sem envolvimento sistémico. [1][2][3][4][5][6][7] A vasculite causada pelo PTU cursa geralmente com ANCA positivos, mais frequentemente com anticorpos anti-MPO e consequente padrão pANCA. Contudo, estão descritos vários casos com anticorpos anti-PR3, de que resultam ANCA com padrão citoplasmático na imunofluorescência (cANCA), bem como anticorpos antilactoferrina e antielastase humana dos neutrófilos (EHN), cuja detecção não está disponível de forma rotineira.…”

Section: Discussionunclassified

Vasculite Cutânea Leucocitoclásica Induzida Pelo Propiltiouracilo

Matos¹,

Barreiros²,

Coelho³

et al. 2015

SPDV

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O propiltiouracilo (PTU) é um fármaco largamente usado no tratamento do hipertiroidismo. Em regra bem tolerado, está contudo fortemente associado a anticorpos anticitoplasma dos neutrófilos (ANCA) e, numa minoria dos casos, a vasculite com ANCA positivos, que caracteristicamente ocorre tardiamente. Os autores descrevem o caso de uma mulher de 45 anos, medicada havia 3 anos com PTU no contexto de doença de Graves, observada por quadro clinico sugestivo de vasculite cutânea leucocitoclásica ANCA positiva sem envolvimento sistémico, a qual foi inicialmente interpretada como idiopática e posteriormente associada à toma de PTU. Após a suspensão deste fármaco, assistiu-se a uma melhoria progressiva e mantida, permanecendo a doente assintomática com 3 anos de seguimento.

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Propylthiouracil‐induced DRESS syndrome confirmed by a positive patch test

Cited by 13 publications

References 6 publications

A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions

A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions

Drug reaction with eosinophilia and systemic symptom in a patient with pneumonia and hyperthyroidism

Vasculite Cutânea Leucocitoclásica Induzida Pelo Propiltiouracilo

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