Clin-Alert®Pub Date : 2017-02-01DOI: 10.1177/0069477017694336
T. Mcevoy
{"title":"Reporting on Adverse Clinical Events","authors":"T. Mcevoy","doi":"10.1177/0069477017694336","DOIUrl":"https://doi.org/10.1177/0069477017694336","url":null,"abstract":"A 43-year-old female patient developed sudden bilateral hearing loss, ataxia, and vertigo approximately 20 days after starting metronidazole (total dose = 28 g) as part of a regimen for the treatment of Helicobacter pylori. A physical examination revealed lethargy, encephalopathy, slurred speech, and apathy. Despite normal muscle tone, the muscle force was decreased on the right side of the body. Screenings for infectious etiologies were negative. A brain magnetic resonance imaging demonstrated bilateral symmetric T2-weighted hypersignal lesions in dentate nucleus, the splenium of corpus callosum, and cerebral white matter. Metronidazole was discontinued and treatment with L-carnitine and coenzyme Q10 was initiated with significant improvements observed in hearing and walking within 3 days. The authors concluded that this patient experienced metronidazoleinduced encephalopathy and neurotoxicity based on the temporal relationship between the administration of the drug and the appearance and resolution of symptoms. Suggested mechanism of action included mitochondrial dysfunction, inhibition of protein synthesis by binding to neural RNA, and modifying cerebellar and vestibular g-aminobutyric acid receptors. Metronidazole [“Flagyl”] Agah E et al (A Tafakhori, NeuroImmunology Research Association, Universal Scientific Education and Research Network, Tehran, Iran; e-mail: a_tafakhori@sina.tums.ac.ir) Metronidazole-induced neurotoxicity presenting with sudden bilateral hearing loss, encephalopathy, and cerebellar dysfunction. Eur J Clin Pharmacol 73:249–250 (Feb) 2017","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134344109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clin-Alert®Pub Date : 2017-01-01DOI: 10.1177/0069477016689365
T. Mcevoy
{"title":"Reporting on Adverse Clinical Events","authors":"T. Mcevoy","doi":"10.1177/0069477016689365","DOIUrl":"https://doi.org/10.1177/0069477016689365","url":null,"abstract":"A 35-year-old female patient developed throbbing headaches approximately 5 days after the delivery of a newborn. Additional symptoms, which appeared 10 days after delivery, included tongue heaviness, difficulty speaking, right-sided weakness, tingling, and decreased sensation. No medications were noted in the report but the patient admitted to a long history of chewing khat. A physical examination on hospitalization revealed normal results with the exception of the neurological examination, which indicated a right facial droop and reduced power of her right upper and lower extremities. Laboratory values were within normal limits, and screenings for infectious etiologies were negative. However, a magnetic resonance imaging of the brain revealed an acute left frontal lobe ischemic infarct. A magnetic resonance angiography of the head indicated vasoconstriction of the proximal anterior, middle, and posterior cerebral arteries. A diagnosis of postpartum reversible cerebral vasoconstriction syndrome was decided. Treatment included the administration of verapamil. Follow-up at 1 week demonstrated significant improvement in the vasospasm with complete resolution noted at a 3-month follow-up. The authors concluded that khat ingestion (chewing) was a contributing factor as a vasoactive substance in the development of postpartum reversible cerebral vasoconstriction syndrome in this patient. The authors suggested that clinicians be aware of the possible effects of khat and its use. Khat [Khat] Baharith H & Zarrin A (H Baharith, Department of Medicine, New York Methodist Hospital, Brooklyn, NY; e-mail: Harith.baharith@medportal.ca) Khat—a new precipitating factor for reversible cerebral vasoconstriction syndrome: a case report. J Med Case Rep 10:351 (Dec) 2016","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"308 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115441344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clin-Alert®Pub Date : 2017-01-01DOI: 10.1177/0069477017691038
{"title":"Reporting on Adverse Clinical Events","authors":"","doi":"10.1177/0069477017691038","DOIUrl":"https://doi.org/10.1177/0069477017691038","url":null,"abstract":"A 7-year-old patient developed thunderclap headaches shortly after receiving chemotherapy for the treatment of B-cell precursor acute lymphoblastic leukemia. The patient had already completed induction therapy, early intensification, and intensification without event. The headaches occurred on days 6 and 7 of reinduction, after receiving oral dexamethasone (10 mg/m daily from day 1), vincristine (1.5 mg/m) and pirarubicin (25 mg/m) on day 1, and L-asparaginase (10 000 U/m on days 1 and 4). A cerebral magnetic resonance angiography revealed cerebral vasoconstriction. Chemotherapy was continued with adjunctive nifedipine without further recurrence until the entire chemotherapy regimen was completed. Reversible cerebral vasoconstriction syndrome was diagnosed. A repeat angiography at 5 months demonstrated normal vessels. The authors concluded that this patient developed reversible cerebral vasoconstriction syndrome in relation to chemotherapy based on the temporal relationship between the administration of the drugs and onset and resolution of symptoms. They noted that antineoplastics are not typically associated with this syndrome but that a few pediatric case reports have been previously published. Chemotherapy [“Vincristine,” “Pirarubicin,” “L-Asparaginase”] Aoki T et al (T Aoki, Department of Hematology/Oncology, Saitama Children’s Medical Center, Chiba, Japan) Reversible cerebral vasoconstriction syndrome during chemotherapy for acute lymphoblastic leukemia. J Pediatr 180:284 (Jan) 2017","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125325713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clin-Alert®Pub Date : 2016-12-01DOI: 10.1177/0069477016684568
{"title":"Reporting on Adverse Clinical Events","authors":"","doi":"10.1177/0069477016684568","DOIUrl":"https://doi.org/10.1177/0069477016684568","url":null,"abstract":"A 43-year-old female patient was hospitalized with chest pain and dysphagia after eating solids and liquids that developed approximately 1 day after starting oral clindamycin (300 mg), which had been prescribed as presurgical prophylaxis. No concurrent medications were noted in this report. Additional symptoms included a constant squeezing pain behind the breastbone, which spread to the upper stomach and back and was worsened by swallowing and movement. A physical examination revealed no other underlying medical issues. Laboratory screenings for cardiac and infectious etiologies were negative. An esophagogastroduodenoscopy revealed severe necrosis in the distal esophagus, with insufficient gastric cardia. Treatment included a spasmolytic and a proton pump inhibitor at full dose for 7 days and at half-dose for an additional 3 weeks. The use of clindamycin was also discontinued. At follow-up, 1 month later, a repeat esophagogastroduodenoscopy revealed no strictures, ulcers, erosions, and bleeding, but mild gastroesophageal reflux disease was present. Within 3 weeks of proton pump inhibitor therapy, there was complete resolution. It was recommended to continue on a proton pump inhibitor and to avoid clindamycin. The authors concluded that this patient developed necrotizing esophagitis related to clindamycin based on the temporal relationship between the administration of the drug and the appearance and resolution of symptoms. They noted that necrotizing esophagitis has been reported with the use of nonsteroidal anti-inflammatory agents but that this was the first case report noted with clindamycin. According to the Naranjo causality scale, this reaction was classified as probable. Clindamycin [Clindamycin] Benić MS (MS Benić, Department of Clinical Pharmacology and Toxicology, Clinical Hospital Centre Rijeka, Krešimirova 42, Rijeka 51000, Croatia; e-mail: mirji.stanic@gmail.com) Clindamycin-induced necrotising oesophagitis. Postgrad Med J 92:741 (Nov) 2016","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128248888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
求助内容：
应助结果提醒方式：