Predictors of DHRs against asparaginase and other biological agents relate to antigen presentation (HLA-DRB1 and HLA-A alleles, respectively). [ncbi.nlm.nih.gov]

• Generalized Lymphadenopathy

  Alf Björnberg and Rolf Holst, GENERALIZED LYMPHADENOPATHY AS A DRUG REACTION TO HYDANTOIN, Acta Neurologica Scandinavica, 43, 3, (399-402), (2009). [doi.org]

• Fever

  It is characterized by rash, fever, and internal organ involvement. It may present in different clinical forms. We present a case of acute generalized exanthematous pustulosis occurring as a manifestation of AHS. [ncbi.nlm.nih.gov]

  Within 24 hours his fever resolved. Over the following week his liver enzymes, C reactive protein concentration, and skin returned to normal. [bmj.com]

  This syndrome is a severe, idiosyncratic multi-system reaction defined by the clinical triad of fever, rash and internal organ involvement (e.g. hepatitis, myocarditis, nephritis or pneumonitis), which may occur 1 - 8 weeks after medicine exposure.1 Fever [medsafe.govt.nz]

• Malaise

  The most common presentations in patients with DHS are fever, which ranges from 38 C to 40 C and occurs in 85% of cases, malaise, pharyngitis, and cervical lymphadenopathy. [mdedge.com]

  As with serum sickness, the rash is usually preceded by a prodromal phase consisting of fever, malaise, and lymphadenopathy. Viral infections must be ruled out, as they can mimic SSLR. [uspharmacist.com]

  The syndrome may be mild (with arthralgias, fever, and rash) or fairly dramatic (with serositis, high fevers, and malaise), but it tends to spare the kidneys and CNS. The antinuclear antibody test is positive. [msdmanuals.com]

  The syndrome may be mild (with arthralgias, fever, and rash) or fairly dramatic (with serositis, high fevers, and malaise), but it tends to spare the kidneys and central nervous system. The antinuclear antibody test is positive. [merckmanuals.com]

• Unconsciousness

  Opioid-intoxication, as for example a morphine overdose leads to unconsciousness, hypoventilation and miosis. The probability of an ADE differs from substance to substance. [intechopen.com]

• Sneezing

  Allergic reactions can range from the mild (sneezing and runny nose, or a few hives) to the severe (anaphylaxis or cardiopulmonary arrest). [brighamandwomens.org]

  Allergic rhinitis: Release of the above mediators in the upper respiratory tract can result in sneezing, itching, nasal congestion, rhinorrhea, and itchy or watery eyes. [emedicine.medscape.com]

• Nausea

  Two weeks following therapy, the patient developed fever, skin rash, nausea, and headache. The next day, the patient became anuric. There was no family history of renal or hepatic disease. [mdedge.com]

  No nausea and vomiting, loss of appetite three days before entering the hospital. Patients gained weight in the last six months but previously experienced a weight loss of about 5-10 kg in five years. Normal urination and defecation. [omicsonline.org]

  Wait about an hour before lying down Patients should protect skin and nails from sun exposure, as it is photosensitising and can cause unexpected sunburn It can cause nausea, vomiting and diarrhoea; it is better tolerated when taken after food than on [dermnetnz.org]

  These conditions include: Serum sickness, which may cause fever, joint pain, rash, swelling and nausea Drug-induced anemia, a reduction in red blood cells, which can cause fatigue, irregular heartbeats, shortness of breath and other symptoms Drug rash [mayoclinic.org]

• Abdominal Pain

  A pearl is patients may present with only recurrent episodes of abdominal pain with GI distress (n/v/d) secondary to gut edema. [imrespdx.com]

  pain, diarrhea, hepatomegaly, splenomegaly Skin rash (maculopapular rash, bullous, wheal and flare, plaque, patch, target lesion) Internal organ involvement (liver - elevated alanine aminotransferase levels, kidney, lung); also brain ( Turk J Pediatr [pathologyoutlines.com]

  Drug-induced liver damage Typical externally evident signs of severe liver damage include fatigue, weakness, abdominal pain, nausea, dark urine, jaundice, pruritus, and fever. [ncbi.nlm.nih.gov]

• Aphthous Stomatitis

  Doxycycline is also effective at controlling non-infectious, inflammatory skin and mucosal diseases, including: Acne Rosacea Perioral dermatitis Hidradenitis suppurativa Recurrent aphthous stomatitis Bullous pemphigoid Granulomatous disorders such as [dermnetnz.org]

• Arthralgia

  Diagnosis of AIN should be considered in any case of rapidly progressive renal failure occurring during drug therapy, especially when fever, skin rash, arthralgias, macroscopic hematuria, and blood or urinary eosinophilia are present. [ncbi.nlm.nih.gov]

  The syndrome may be mild (with arthralgias, fever, and rash) or fairly dramatic (with serositis, high fevers, and malaise), but it tends to spare the kidneys and CNS. The antinuclear antibody test is positive. [msdmanuals.com]

  Additionally, hypotension, bleeding, interstitial nephritis, arthralgia, arthritis, myositis, thyroiditis, pneumonitis, respiratory distress syndrome, pericarditis, myocarditis, pancreatitis, colitis, orchitis, encephalitis, and aseptic meningitis have [mdedge.com]

  Some distinct clinical syndromes can involve other types of hypersensitivity reactions: Serum sickness: This reaction typically occurs 7 to 10 days after exposure and causes fever, arthralgias, and rash. [merckmanuals.com]

• Urticaria

  The present study aimed to investigate the relationship between NH and chronic urticaria, rhinitis/rhinosinusitis, and asthma in an effort to identify NH phenotypes. [ncbi.nlm.nih.gov]

• Skin Rash

  The syndrome is defined by the clinical triad of fever, skin rash and internal organ involvement and can be life-threatening condition. We describe three patients treated in our institution. [ncbi.nlm.nih.gov]

  This is quickly followed by a widespread skin rash. Characteristics of the rash are diverse. [dermnetnz.org]

• Pruritus

  This is a case of a young person who initially presented with a dramatic episode of unilateral arm swelling after injuring a finger, with subsequent episodes of recurrent localized edema without pruritus throughout their body, including episodes of gut [imrespdx.com]

  ampicillin sulbactam 4 g/d 0.5 g/d, ciprofloxacin 750 mg/d, fluconazole 200 mg/d) – growth factors such as filgrastim DILI – H1 blockers for pruritus DRESS (type IVb) – antipyretic drugs for fever – H1 blockers for pruritus – glucocorticoids, plasmapheresis [ncbi.nlm.nih.gov]

• Eczema

  Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006 Aug 26. 368(9537):733-43. [Medline]. [emedicine.medscape.com]

  […] eosinophilia and systemic symptoms (DRESS) Stevens-Johnson syndrome / Lyell syndrome (synonym: toxic epidermal necrolysis) (SJS/TEN) drug-induced liver injury (DILI) drug-induced renal injury (DIRI) Contact allergies of the skin, usually consisting of contact eczema [ncbi.nlm.nih.gov]

• Chronic Urticaria

  The present study aimed to investigate the relationship between NH and chronic urticaria, rhinitis/rhinosinusitis, and asthma in an effort to identify NH phenotypes. [ncbi.nlm.nih.gov]

  Molecular genetic mechanisms of chronic urticaria. Allergy Asthma Immunol Res 2014;6:13–21. 50. Sanak M, Pierzchalska M, Bazan-Socha S, Szczeklik A. [kjim.org]

  Forty-one patients were excluded: 27 because of a clinical history incompatible with a drug hypersensitivity reaction, 6 because of HIV, 2 because of chronic urticaria, 4 because of food or latex allergy, and 2 because of severe cutaneous reactions. [jamanetwork.com]

  urticaria refractory to high dose treatment with H1 antihistamines (ref60) and is now FDA approved for refractory chronic urticaria. [emedicine.medscape.com]

  Fujisawa D, Kashiwakura J, Kita H, Kikukawa Y, Fujitani Y, Sasaki-Sakamoto T, Kuroda K, Nunomura S, Hayama K, Terui T, Ra C, Okayama Y: Expression of Mas-related gene X2 on mast cells is upregulated in the skin of patients with severe chronic urticaria [doi.org]

• Macroscopic Hematuria

  Diagnosis of AIN should be considered in any case of rapidly progressive renal failure occurring during drug therapy, especially when fever, skin rash, arthralgias, macroscopic hematuria, and blood or urinary eosinophilia are present. [ncbi.nlm.nih.gov]

• Headache

  Two weeks following therapy, the patient developed fever, skin rash, nausea, and headache. The next day, the patient became anuric. There was no family history of renal or hepatic disease. [mdedge.com]

  […] blood pressure Lung disease, causing shortness of breath and cough (interstitial pneumonitis, pleuritis, pneumonia and acute respiratory distress syndrome) Neurological involvement, which may lead to meningitis and, encephalitis, polyneuritis, causing headache [dermnetnz.org]

In this study, we aimed to assess the frequency of confirmed NSAID hypersensitivity in children with a previous reported reaction to NSAID in order to investigate the role of the drug provocation test (DPT) in the diagnostic workup and to explore the [ncbi.nlm.nih.gov]

See this previous report for the differential of bilateral lower extremity edema. 2) C3 and C4 complement levels can be used in a workup of vasculitis to help distinguish pauci-immune vasculidities (they are normal). 3) Hereditary angioedema is an extremely [imrespdx.com]

Considering that treatment for tuberculosis requires long-term management with several drugs, it is important to refrain from administering drugs that can cause DIHS during tuberculosis treatment. [ncbi.nlm.nih.gov]

The clinical recognition that GCM may be a manifestation of an adverse drug reaction is important, since the prognosis and treatment of this entity may be different from that of other forms of myocarditis. [ncbi.nlm.nih.gov]

Samter's triad include asthma, aspirin sensitivity, and nasal/ethmoidal polyposis: ASP irin A sthma S ensitivity to aspirin P olyps T T oxic epidermal necrosis (TEN) T hirty percent of the skin (SJS less than 10%) " T errible" prognosis Management of [allergycases.blogspot.com]

The effect of corticosteroids on prognosis is unknown as controlled clinical trials are lacking.2 Beware of cross-reactions and family predisposition Cross-hypersensitivity reactions are common between the three main aromatic anticonvulsants (i.e. phenytoin [medsafe.govt.nz]

The classification and etiology of hypersensitivity reactions The etiology of type I allergic reactions Type I allergy involves the IgE-mediated elaboration of inflammatory mediators such as histamine, heparin, tryptase, platelet-activating factor, and [ncbi.nlm.nih.gov]

We review the epidemiology of severe drug hypersensitivity reactions with a particular focus on severe cutaneous adverse reactions (SCARs). [ncbi.nlm.nih.gov]

Besides epidemiological aspects, it addresses the immunological mechanisms underlying these complicated reactions which go far beyond the IgE-mediated drug allergies also considered in the book. [karger.com]

This review focuses on the current knowledge of the epidemiology, pathophysiology and clinical features of drug hypersensitivity reactions of drugs used in the management of the HIV -infected patient. [journals.lww.com]

Drug hypersensitivity reactions still remain one of the most challenging problems in allergology due to their manifold clinical manifestations and their very diverse pathophysiology. [ncbi.nlm.nih.gov]

The increased predisposition of drug hypersensitivity disease in HIV will continue to provide a fertile ground for study of the diverse and complex processes that drive its pathophysiology. [journals.lww.com]

[…] is unknown The underlying mechanisms causing DHS are poorly understood.1 Defective detoxification of reactive oxidative metabolites1 and a genetic predisposition4 have been implicated in the pathophysiology of this syndrome, as has slow acetylator status [medsafe.govt.nz]

Elucidating the mechanisms of drug hypersensitivity will not only help to identify patients at risk but will also provide novel insights into the pathophysiology of numerous immune-mediated diseases. [karger.com]

HLA-B*57:01 screening to prevent abacavir hypersensitivity exemplifies a successful translational roadmap from pharmacogenomic discovery through to widespread clinical implementation. [ncbi.nlm.nih.gov]

Articles in this issue include: Drug allergy diagnosis; Principles of drug allergy management: acute drug reactions, individual preventive measures, desensitization, general preventive measures; Antibiotics allergy; Non-steroidal anti-inflammatory drugs [books.google.com]

Lack of understanding of the mechanisms of these reactions, and therefore the development of diagnostic, predictive, and preventive strategies remains an unmet medical need. [aaaai.org]