Que poesia e essa?!...poesia marginal

Lamotrigin-Induced Dress Syndrome: An Idiosyncratic Reaction

“…IL-33 induces cutaneous macrophages, attracts type 2 innate lymphocytes and causes eosinophilia . (1) There are 4 main mechanisms that induce the syndrome: polymorphisms of HLA alleles, polymorphisms of liver enzymes such as cytochrome P450 and N-acetyltransferase (NAT1 and 2), deficiency of the enzyme epoxy hydroxylase and reactivation of the herpes virus . (1,4) HLA polymorphisms modify the histocompatibility complex (MHC) with interaction between the drug, the T cell receptor and antigen presenting cells (APCs).…”

“…(1) There are 4 main mechanisms that induce the syndrome: polymorphisms of HLA alleles, polymorphisms of liver enzymes such as cytochrome P450 and N-acetyltransferase (NAT1 and 2), deficiency of the enzyme epoxy hydroxylase and reactivation of the herpes virus . (1,4) HLA polymorphisms modify the histocompatibility complex (MHC) with interaction between the drug, the T cell receptor and antigen presenting cells (APCs). Functional alterations of liver enzymes contribute to the accumulation of toxic metabolites, for example, the enzyme epoxy hydroxylase generates hydroxylation of aromatic anticonvulsants and its deficiency produces free radicals and cell damage .…”

“…Functional alterations of liver enzymes contribute to the accumulation of toxic metabolites, for example, the enzyme epoxy hydroxylase generates hydroxylation of aromatic anticonvulsants and its deficiency produces free radicals and cell damage . (1,4) After absorption, the drug or metabolite reaches the bloodstream and is captured by antigen-presenting cells that contain HLA in the membrane. In the HLA-drug complex, the hapten is presented to naive T cells through the T cell receptor and triggers several types of immune reaction.…”

“…It is associated with herpes virus infection, HLA B alleles, polypharmacy, autoimmune diseases and enzyme polymorphisms such as slow N-acetylator and cytochrome P450. (1,4,5) The most related drugs are aromatic anticonvulsants (carbamazepine, phenytoin, phenobarbital, lamotrigine), allopurinol, minocycline, dapsone, vancomycin, sulfa drugs. Comorbidities that increase the risk include HIV, epilepsy, atopy, collagenosis, renal or hepatic failure .…”

“…Comorbidities that increase the risk include HIV, epilepsy, atopy, collagenosis, renal or hepatic failure . (1,2) DRESS is characterized by fever, extensive mucocutaneous rash, lymphadenopathy, eosinophilia and atypical lymphocytes, evolving with organ dysfunction. Cutaneous manifestations are common due to the presence of memory effector cells.…”