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The principle treatment for DPD-deficient patients with severe acute 5-FU reactions is supportive care; however, the administration of thymidine potentially may reverse severe 5-FU-induced neurologic symptoms such as encephalopathy and coma.
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In addition, aggressive supportive measures to manage renal failure (hemodialysis) and labile hypertension, allowed this patient to have an extended survival as a result of successful therapy for this complication despite an underlying rapidly fatal malignancy.
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Such might not be the case with newer technologies.
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"Retinoic acid syndrome" was prevented with short-time treatment of high dose (4 x 1.5 g/m2) cytarabine.
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OBJECTIVE: To describe what is believed, as of November 4, 2003, to be the first case published in the literature of acute interstitial nephritis (AIN) due to pantoprazole.
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Children receiving zonisamide should be monitored for oligohidrosis and the development of neurological symptoms associated with an elevation of body temperature.
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Fatal interstitial pneumonitis associated with docetaxel administration in a patient with hormone-refractory prostate cancer.
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A water deprivation test demonstrated a nephrogenic diabetes insipidus.
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Fever recurred 30 days after his initial presentation, and blood smear-positive vivax malaria was diagnosed.
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Increasingly, the cytotoxic agent amifostine is being used prior to radiotherapy in an attempt to decrease associated morbidities.
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Although the data indicate an immune-complex cause for gold-salt nephropathy, the incident antigen (or antigens) and mechanism of action remain unidentified.
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The possibility of phenytoin hypersensitivity reactions should be considered when patients receiving phenytoin have unusual symptoms, particularly fever, rash, and lymphadenopathy.
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Hepatopathy subsided after the cessation of carbamazepine and lynestrenol.
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Such reactions have been described in patients receiving certain drugs such as 5-nitroimidazoles, nitrofurans, sulfonylureas and certain newer cephalosporins with a methyltetrazolethiol side chain.
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In May 1996, as part of his routine antihepatitis B (hepB) vaccination plan, a 28-year-old HbsAg-negative man, hospital worker, received his first dose (20 microg) of a recombinant vaccine (EngerixB-B, Smith Kline and Beecham, Belgium), administered via deltoid injection.
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One type of SMON is associated with acrodermatitis enteropathica which has a very high frequency of occurrence in association with administration of clioquinol.
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Post-influenza vaccine chronic inflammatory demyelinating polyneuropathy.
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Diagnosis was made by serial blood glucose determinations during a 20- to 24-hour period after insulin administration.
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RESULTS: The patient underwent anticoagulation therapy without removal of screw.
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We present the first case of osteomyelitis in a patient receiving infliximab therapy for severe psoriasis and psoriatic arthritis.
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He recovered without complications with imipenem-cilastatin prophylaxis.
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Stupor from lamotrigine toxicity.
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Acyclovir neurotoxicity: clinical experience and review of the literature.
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The reversal of heparin by protamine may cause severe hemodynamic deterioration, characterized by systemic hypotension, pulmonary hypertension, and bronchoconstriction.
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A 47-year-old woman received an allogeneic bone marrow infusion because of chronic myeloid leukemia.
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The case history and toxicological findings of an infant fatality involving pseudoephedrine, brompheniramine, and dextromethorphan are presented.
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In previous reports, three of four patients with TSHoma displayed Graves' disease after tumor resection, and TSH is also known to play a major role in regulating immunomodulatory gene expression in thyrocytes.
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After five and six weeks of continuous oral administration of methylprednisolone, the boys developed steroid diabetes.
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Severe chronic active Epstein-Barr virus infection is a rare, debilitating, nonneoplastic, inflammatory disorder for which there is no definitive treatment.
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Evaluation revealed CMV viremia with a high viral load and CMV gastritis was confirmed using gastroscopy and histopathologic examination.
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A 40-year-old woman presented with an unusual form of corneal herpetic reactivation 5 weeks after laser in situ keratomileusis.
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There is no consensus on the treatment of ticlopidine-induced marrow aplasia.
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The activity of the circulating anticoagulant and the BFP disappeared within days following discontinuation of procainamide and the administration of corticosteroids.
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The long P-P intervals ranged between 1.04-1.12 s and the short P-P intervals between 0.80-0.84 s, respectively.
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Orthostatic hypotension and vertigo are not consistent with the patients' histories.
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Nonsurgical management of ectopic pregnancy associated with severe hyperstimulation syndrome.
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Ciprofloxacin-induced hemorrhagic vasculitis.
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Pemphigus vulgaris is a rare auto-immune blistering disease that can also be life-threatening.
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Subcutaneous IL-2 is safe and well tolerated, with a mortality rate <3%.
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Clinical presentation spreads from almost asymptomatic patients to critically ill patients with pulmonary oedema or frank cardiogenic shock.
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All-trans retinoic acid-induced focal myositis, synovitis, and mononeuritis.
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Prenatal cytomegalovirus (CMV) infection associated with severe brain damage was detected in an infant whose mother had been treated with prednisolone and azathioprine for systemic lupus erythematosus (SLE).
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In some cases this seems to happen because spironolactone causes diarrhoea.
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Kaposi's sarcoma (KS) is an unusual tumor principally affecting the skin of the lower extremities.
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However, prolongation of 5-FU half-life and an increase in INR have been reported with the concurrent use of 5-FU and warfarin.
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The patient had a history of environmental allergies.
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Optimal medical management may not be widely recognized.
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The TC occurred in the absence of hyperparathyroidism or a high calcium x phosphate product as evidenced by hormonal and biochemical examination as well as by a bone biopsy specimen that revealed an adynamic bone disease with significant aluminum staining.
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A 2-year-old mentally retarded boy with frontal lobe epilepsy presented with an episode that resembled heat stroke during the administration of zonisamide.
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In a prospective study, we found that 10 of 19 diabetic patients (53%) who had received insulin containing insulin also had high levels of antiprotamine immunoglobulin E.
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We present a report summarizing our experience and problems with six patients who had a clinical picture of NE and offer a short review of the current literature on the subject.
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Diphenhydramine, a common ingredient in over-the-counter medications, is often taken in overdose.
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A 36-year-old white man had both acute intermittent porphyria and long-standing idiopathic grand mal seizures.
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Female renal allograft recipients who develop CMV infection during pregnancy are at risk for both graft dysfunction and fetal morbidity.
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Twenty-four-hour ambulatory pH monitoring demonstrated decreased acid reflux 8 weeks after withdrawal of nifedipine, with coincidental symptomatic and endoscopic improvement.
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We report a case of exfoliative dermatitis clearly linked to intravenous and intraperitoneal administration of tobramycin.
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By the 10th ICU day, the patient's respiratory and mental status improved and the patient was successfully extubated.
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Investigations confirmed a leucopenia and neutropenia.
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Serologic evaluations on presentation ruled out infectious diseases or other etiological factors.
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CONCLUSIONS: The use of IL-2 in bedridden patients with performance status >2 must be given on an individualized basis.
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CONCLUSIONS: When central nervous system findings are observed in renal transplant recipients, nocardial brain abscess must be considered in the differential diagnosis.
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Depending upon the severity of the exacerbation and the type of organ involvement, reactivation of sarcoidosis may require discontinuation of the interferon therapy, with or without the use of additional steroids.
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Class effect of erythropoietin therapy on hemoglobin A(1c) in a patient with diabetes mellitus and chronic kidney disease not undergoing hemodialysis.
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Pathologic specimens obtained by open lung biopsy showed thickening of the wall from the distal bronchioli to the alveolar ducts due to submucosal and intraepithelial infiltration of lymphocytes, histiocytes and foamy macrophages, which was not accompanied by organizing changes.
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Hepatitis B virus reactivation in a patient undergoing steroid-free chemotherapy.
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To our knowledge, these cases represent the first reports of TDF-associated irreversible renal failure and rickets in pediatric patients.
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The children who received appropriate therapy had a favorable outcome.
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Bone marrow or stem cell transplantation is an established therapy for haematological malignancies.
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We describe a possible drug interaction between these two drugs and recommend that they should only be used together with caution.
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Despite appropriate therapy, the microangiopathic process was irreversible and the patient died.
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We report on three patients with acute schizophrenia, who developed severe akathisia during treatment with olanzapine (20-25 mg/d).
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Experience in the current case suggests that preventive measures for tumor lysis syndrome, including allopurinol and hydration, should be taken for patients with high leukemia burden who receive imatinib therapy, and parameters of tumor lysis should be monitored in the early phase of therapy.
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With the use of the newer antidepressants beyond the traditional tricyclics and monoamine oxidase inhibitors, newer options in headache prophylaxis are provided as well as the potential for undesirable and even potentially life-threatening interactions between medications.
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Diagnosis was confirmed by polymerase chain reaction (PCR) detection of donor DNA in the patient, by amplification of Y-chromosome sequence and analysis of minisatellite polymorphisms.
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BACKGROUND: Although most patients receiving insulin produce insulin-specific IgE, significant allergic symptoms develop in very few of them.
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Observations in our patient suggest that the leukoencephalopathy that developed in previously reported patients who received 5-fluorouracil and levamisole may have been caused at least partly by levamisole.
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The implications for the long-term effects of phenelzine treatment are considered.
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Nimesulide should be added to the list of agents associated with this serious adverse drug reaction.
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A 19-year-old woman was admitted with acute severe asthma in her eleventh week of pregnancy.
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The case demonstrates that hypersensitivity reaction to pranlukast and resultant ATIN is possible, and that periodic urine testing in patients receiving pranlukast should be considered.
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MCD was steroid-resistant type.
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Cancer patients with decreased DPD activity are at increased risk for severe toxicity including diarrhea, stomatitis, mucositis, myelosuppression, neurotoxicity, and, in some cases, death.
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The patient had a history of alcohol abuse; alcohol intake as well as withdrawal can also cause seizures.
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The results in this case suggest that cyclosporin is an effective agent in patients with severe sight threatening Mooren's ulcer.
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Weakness of the right arm, focal seizures, lethargy and confusion appeared on day 10.
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An indirect immunofluorescence test for ANCA was positive.
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A case of a 21-year-old woman who had developed mild hepatotoxicity while receiving choline magnesium trisalicylate therapy is described.
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A 600-mg loading dose appears to shorten the time to achieve an adequate antiplatelet effect to about two hours.
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However, the thrombocytosis did not resolve.
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Amiodarone hydrochloride, a new antiarrhythmic agent, has been associated with pulmonary toxicity characterized by cough, dyspnea and diffuse pulmonary infiltrates.
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RESULTS: The 3 patients were men, aged 39, 42, and 43 years.
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Biopsy specimens from the oral mucosa and forearm revealed small brown-black granules scattered in the dermis and basal lamina of eccrine sweat glands, blood vessels, and hair follicles under the light microscope.
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Hypersexuality with antiparkinsonian therapy.
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He was transferred when he developed pancytopenia, fever, severe mucositis, ileus and peripheral neuropathy.
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Perilesional linear atrophic streaks associated with intralesional corticosteroid injections in a psoriatic plaque.
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CONCLUSIONS: This report indicates clindamycin phosphate vaginal cream as the most probable cause of CDIC due to the temporal relationship between the occurrence of diarrhea and clindamycin administration, lack of concomitant medications, and documentation of C. difficile toxin.
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The dermatology literature heretofore has not noted that anemia is a side effect of patients taking MMF to treat pemphigus.
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Consequently, the treatment was immediately stopped.
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A causal relationship between high doses of thyroid hormone and the presumptive impairment of endogenous TRH reserve is suggested.
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The paper discusses the imputability of benfluorex, a drug used as an adjuvant in hypercholesterolemia, structurally related to amphetamines.
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