Asunto(s)
Erupciones por Medicamentos/etiología , Inmunoglobulina G/efectos adversos , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Urticaria Pigmentosa/inducido químicamente , Adulto , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/patología , Etanercept , Femenino , Humanos , Inmunoglobulina G/uso terapéutico , Factores Inmunológicos/efectos adversos , Factores Inmunológicos/uso terapéutico , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Urticaria Pigmentosa/diagnóstico , Urticaria Pigmentosa/patologíaRESUMEN
Antiepileptic drugs including lamotrigine (LTG) and carbamazepine (CBZ) are among the most common causes of cutaneous adverse reactions (cADRs). Human leukocyte antigen (HLA)-B*1502 has been strongly associated with CBZ-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). To investigate this relationship, we performed high-resolution HLA genotyping on LTG-tolerant controls, healthy volunteers, and patients affected by LTG-induced cADRs, ranging from maculopapular exanthema (MPE) to SJS/TEN. Patients with LTG-induced cADRs (n=25, including three with SJS/TEN and 22 with MPE), 21 LTG-tolerant controls, and 71 healthy volunteers were enrolled. The differences in the starting dosage of LTG among the SJS/TEN, MPE, and LTG-tolerant control groups were not statistically significant. HLA-B*1502 frequency was 33.3% (1/3; LTG-induced SJS/TEN group), 9.1% (2/22; LTG-induced MPE group), 4.8% (1/21; LTG-tolerant group), and 8.5% (6/71; healthy volunteers). There was no significant difference in the frequency of subjects with the HLA-B*1502 allele between the SJS/TEN group and LTG-tolerant group (p=0.239, OR=10.0, 95% CI 0.44-228.7), and healthy volunteers (p=0.26, OR=5.42, 95% CI 0.43-68.8), MPE and LTG-tolerant groups (p=1.0, OR=1.08, 95% CI 0.20-5.8), and healthy volunteers (p=1.0, OR=2.0, 95% CI 0.17-23.9). None of the HLA alleles detected were associated with LTG-induced cADRs. In conclusion, HLA-B*1502 and other HLA alleles are not directly associated with LTG-induced MPE. The possibility that HLA-B*1502 is associated with an increased risk of LTG-induced SJS/TEN could not be excluded.
Asunto(s)
Anticonvulsivantes/efectos adversos , Antígenos HLA-B/genética , Síndrome de Stevens-Johnson/inducido químicamente , Triazinas/efectos adversos , Urticaria Pigmentosa/inducido químicamente , Adolescente , Adulto , Pueblo Asiatico/etnología , Epilepsia/tratamiento farmacológico , Epilepsia/genética , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Lamotrigina , Masculino , Adulto JovenAsunto(s)
Enfermedades del Tejido Conjuntivo/tratamiento farmacológico , Fitoterapia/efectos adversos , Extractos Vegetales/efectos adversos , Urticaria Pigmentosa/inducido químicamente , Urticaria Pigmentosa/patología , Tejido Adiposo/efectos de los fármacos , Tejido Adiposo/patología , Corticoesteroides/uso terapéutico , Adulto , Biopsia con Aguja , Enfermedades del Tejido Conjuntivo/etiología , Enfermedades del Tejido Conjuntivo/patología , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Inyecciones Subcutáneas , Obesidad/complicaciones , Extractos Vegetales/uso terapéutico , Medición de Riesgo , Índice de Severidad de la Enfermedad , Urticaria Pigmentosa/tratamiento farmacológicoRESUMEN
UNLABELLED: Mastocytosis in children shows in three clinical forms. The rarest is the diffuse or bullous form. CASE REPORT: Since one month of age an infant showed a diffuse erythema and vesicle rash. At four months of age, serious discomfort after morphinic absorption led to the diagnosis of bullous cutaneous mastocytosis. Histologic examination confirmed this diagnosis. The clinical severity led to intravenous corticosteroid and antihistamine therapy. COMMENTS: Bullous cutaneous mastocytosis is unusual in children. However, it should be considered if there are any doubts because of its serious complications and iatrogenic therapeutic risks. Some serious cases require intravenous corticosteroid therapy. Appropriate care enables a normal development with a disappearance of the disease before the teenage years.
Asunto(s)
Analgésicos Opioides/efectos adversos , Morfina/efectos adversos , Urticaria Pigmentosa/inducido químicamente , Enfermedad Aguda , Corticoesteroides/uso terapéutico , Diagnóstico Diferencial , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Humanos , Enfermedad Iatrogénica , Lactante , Masculino , Índice de Severidad de la Enfermedad , Urticaria Pigmentosa/diagnóstico , Urticaria Pigmentosa/patologíaRESUMEN
Plasma aspirin esterase activity and cholinesterase activity were reduced in patients with aspirin sensitive asthma and aspirin sensitive urticaria compared to asthmatic and dermatological controls. Phenylacetate (non specific) esterase activities, were however unaltered in these patients. The reason for the lower activity is uncertain but it does not appear to be due to genetically determined lower cholinesterase or due to the avoidance of aspirin by sensitive patients. A low aspirin esterase activity may be a contributory factor in precipitating these aspirin sensitive reactions.
Asunto(s)
Aspirina/efectos adversos , Asma/enzimología , Esterasas/sangre , Urticaria Pigmentosa/enzimología , Asma/inducido químicamente , Butirilcolinesterasa/sangre , Colinesterasas/sangre , Humanos , Urticaria Pigmentosa/inducido químicamenteRESUMEN
In suckling mice injected intraperitoneally with mitomycin C on the 1st to 5th day after birth and sacrificed in the course of 24 or 48 h after injection, mastocytosis occurred in the oral mucosa membrane, skin of the trunk or extremities and bone marrow of extremities.