ABSTRACT
OBJECTIVE: The objective of this study is to review the published data on ocular toxicity in newborns after in utero exposure to hydroxychloroquine. METHODS: All publications related ophthalmologic follow-up of newborns or infants who were exposed to hydroxychloroquine during pregnancy were selected. RESULTS: Nine studies were analyzed, concerning 246 infants for which an ophthalmological examination was available. None of the infants had signs of ocular toxicity at the clinical stage. Among the 31 infants having electrophysiologics explorations, 4 had suggestive signs of retinal toxicity at the preclinical stage. This could probably be explained by a low cumulative dose, the immaturity of the fetal retina and the low light stimulation in utero. However, without a remote monitoring of infants, it is difficult to conclude to the absence of functional impairment. CONCLUSION: Data are not for a major risk of retinal toxicity associated with exposure in utero to hydroxychloroquine.
Subject(s)
Antirheumatic Agents/adverse effects , Hydroxychloroquine/adverse effects , Retinal Diseases/chemically induced , Antirheumatic Agents/administration & dosage , Dose-Response Relationship, Drug , Female , Humans , Hydroxychloroquine/administration & dosage , Infant, Newborn , Pregnancy , Pregnancy Complications/drug therapy , Retinal Diseases/epidemiology , Retinal Diseases/pathologyABSTRACT
Neurotoxicity is frequent with vincristine treatment, but severe autonomic neuropathy is rare. A decreased activity of drug transporters in the presence of an interacting drug may favor such events by increasing systemic or tissue exposure to the drug. We encountered severe autonomic neuropathy and cholestasis in a child receiving vincristine, after the introduction of piperacillin-tazobactam. A causality assessment of the adverse reaction identified the antibiotic as the most probable cause of the observation. The patient was heterozygous for several common polymorphisms of ABCC2 (multidrug-related protein-2), CYP3A5, and ABCB1 (multidrug-related protein-1, P-glycoprotein), but their role in the toxicity cannot be ascertained.
