Clinical characteristics of elderly patients with disulfiram-like reaction : a retrospective analysis of 19 cases / 中华老年医学杂志

ABSTRACT

Objective To analyze the clinical characteristics of elderly patients with disulfiramlike reaction,in order to raise awareness of this disease.Methods Clinical data of 19 elderly patients diagnosed as disulfiram-like reaction in the emergency department of Beijing Hospital from January 2012 to March 2017 were retrospectively analyzed.Disulfiram-like reaction was diagnosed by comprehensive data of the drugs-induced disulfiram-like reaction,related clinical manifestations,auxiliary examination,treatment response,and by differential diagnosis.Results All of 19 patients were male,with one or more chronic disease,mean ± SD age were 75.6±5.1 years.Of 19 patients,16 patients were taking antibiotics,including ceftriaxone,cefoperazone sodium sulbactam,cefpropene,cefuroxime and moxifloxacin,and other patients received warfarin sodium,glimepiride and metformin before the onset of disulfiram-like reaction.Clinical manifestations of disulfiram like reaction mainly involved the cardiovascular system such as palpitation,chest distress,angina,hypotension,etc.,and might be accompanied by dizziness,facial flushing,awareness disorder,gastrointestinal hemorrhage,renal dysfunction,etc.The myocardial ischemia in ECG was observed in 13 patients,the elevated serum troponin in 3 patients,and a continuing organ dysfunction in 1 patient.Conclusions The elderly patients with disulfiram-like reaction are mainly male,with various pathogenic factors and dangerous prognosis.The symptoms of cardiovascular system are obvious,including arrhythmia,myocardial injury,heart failure,shock and other serious cardiovascular complications.