We evaluated the causality of the association between intrauterine exposure to phenytoin and postnatal neuroblastoma using an in vitro lymphocyte toxicity assay for phenytoin-induced reactions in an unusual sibship. In addition, we investigated intrauterine phenytoin exposure in a case series of infants and children with neuroblastoma diagnosed over 17 years ...

Elastosis perforans serpiginosa is a rare complication of D-penicillamine therapy. It has been reported to occur in Wilson's disease and cystinuria, usually after many years of high-dose therapy. We report a case of D-penicillamine-induced elastosis perforans serpiginosa with unique clinical features occurring in a 10-year-old child with juvenile rheumatoid arthritis ...

Gynecomastia may be physiologic, familial, pathologic, drug-induced or, in many cases, of unknown etiology. Breast enlargement is usually unilateral and asymptomatic. Mechanisms of gynecomastia involve increased estrogen stimulation, decreased testosterone levels or a decreased androgen/estrogen ratio. Hyperprolactinemia is not a cause. Treatment of gynecomastia should be directed at the underlying ...

A case of angiosarcoma of the greater omentum is reported. This angiosarcoma developed 8 years after irradiation for cervical carcinoma and presented with an intra-abdominal hemorrhage. We describe her clinical course, treatment and follow-up. Although several other locations of irradiation-induced sarcomas have been published, this is the first report in ...

Intracranial hypertension with papilledema occurred in two patients receiving danazol therapy for either cyclic neutropenia or immune hemolytic anemia. Results of clinical, laboratory, and neuroradiologic studies showed no apparent cause for the condition in Case 1 and the papilledema resolved one month after discontinuing danazol. Carotid angiography in Case 2 ...

The significance of fragmented activity obtained from the atrium during electrophysiologic study (EP study) was confirmed since it was always observed just at the onset of fibrillation. It was preceded by extra stimuli or atrial flutter, and the initial site of fragmentation varied from case to case. The premature-stimulus-induced widening ...

The occurrence of torsades de pointe is often associated with the use of drugs. We report three cases of amiodarone-induced torsades de pointe. Although a lot of amiodarone-induced torsades de pointe have been published, a review of all these cases and the underlying risk-factors has never been made.

Two cases of organic psychosis, induced by the new chemotherapeutic agent ofloxacin (Tarivid), are described. According to DSM-III-R and ICD 10 (draft, 1987) both cases present as different, yet well-defined diagnostic categories: the new diagnostic systems appear to be superior and markedly more differentiated than ICD-9, since they provide a ...

We report one case of severe accidental hypothermia; rectal temperature was 25 degrees C. Hypoxemia unmodified by 100 O2 inhalation in an ordinary face-mask was easily corrected using a face-mask CPAP; a ventilation-perfusion mismatching could be implicated in the cold induced hypoxemia. Active rewarming (1.5 degrees C/h) was pursued from ...

Hearing loss due to irradiation of the head-and-neck region is a rarely reported complication of such a treatment. Although experimental work had been performed in laboratory animals as early as at the turn of the century, substantiated clinical data in large series are lacking. The few reports published are somewhat ...

A 51-year-old civilian pilot flying a high performance aircraft for the USAF presented for medical attention approximately 1.5 hours after developing substernal chest pain and dyspnea while flying unpressurized at FL 280 (8,534 meters) for 30 minutes. In spite of recompression about 3 hours later, the pilot expired while ascending ...

Transient ST-segment elevation immediately following direct current cardioversion is a clearly documented occurrence in a small percentage of cases. Two main explanations have been suggested: myocardial injury or coronary vasospasm. We report two cases of "intermittent" and transient ST-segment elevation after cardioversion. Such intermittent elevation of the ST segment has ...

A case of an elderly man who developed severe hyponatremia and bone marrow granulomatosis while taking methyldopa is described. The hyponatremia was found to be due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Bone marrow biopsy revealed granulomas. A MEDLINE search of the English literature was done, yielding ...

We report a case in which a defective portable headphone caused ablation of the malleus and removal of the drum. In addition to the warnings already given against the risk of noise-induced hearing loss, a warning should be given against the use of headphones of poor quality. Alternatively, headphones consisting ...

We present here two cases with depression and obsessional symptoms, in which the patients were 11-year-old girls just prior to the advent of menarche. Their clinical picture was fairly different from the one which Deutsch, H., Jacobson, E. and Blos, P. described in their classical cases so far. In our ...

Radial keratotomy (RK), a popular procedure for reducing myopia, does not always have a successful outcome. Of the adverse effects reported in the literature, there have been few reports of undesirable disturbances of binocular vision. Four representative cases are reviewed which presented clinically with varying binocular problems induced by RK. ...

Nine cases of intracranial hemorrhages related to cocaine usage are presented. Another 5 cases from the literature are reviewed. The relationship between severe cocaine-induced hypertension, and the development of subarachnoid or intracerebral hemorrhages is noted, and apparently is related to sudden transient increases of blood pressure related to cocaine use.

Gingival overgrowth induced by diphenylhydantoin (Dilantin) has been well documented in the literature. Recently, there have been other medications with side effects causing Dilantin-like gingival overgrowth. This article presents a case in which diltiazem (Cardizem), a calcium-channel blocker, induced gingival overgrowth. A discussion of the clinical and histologic features and ...

Several adverse dermatologic effects have been reported with the use of warfarin. Among these is the rare complication of drug-induced necrosis. Approximately 150 cases had been reported by 1976, and a review of the literature since 1943 revealed only 4 reported cases of penile necrosis. We present the fifth case ...

Pemoline is an indirectly acting sympathomimetic with actions similar to amphetamine and methylphenidate. While choreoathetosis is a well-recognised complication of acute or chronic amphetamine abuse, only 3 previous case reports have implicated pemoline in such a movement disorder. We report a 49-year-old man who developed severe choreoathetosis with rhabdomyolysis after ...

From the report of Hirschberg, only 3 years after aspirin synthesis, there have been numerous works dedicated to showing the different types of adverse reactions found following aspirin administration. However, there are few publications on the process of urticaria and/or acute angioedema induced by ASA and few reported cases were ...

A case of fatal dilated cardiomyopathy induced by esorubicin (ESO) at a total dose of 740 mg/m2, given in 27 doses over 650 days, is reported. The sudden onset, rapid clinical deterioration, and fatal outcome are detailed. The outcome was not predicted by serial rest ejection fractions or clinical signs. ...

Pneumoparotitis is a rare cause of parotid inflammatory disease in both adults and children. A 12-year-old girl is reported who presented with recurrent bilateral parotid swelling. Radiologic evaluation revealed pneumoparotitis associated with masseter muscle hypertrophy. Further investigation revealed the self-induced nature of the condition in this teenager. Self-induced pneumoparotitis has ...

A 38 year old male dentist developed an oligodendroglioma of the left medial temporal lobe and parasellar region 12 years after radiotherapy with 6600 rads of acromegaly. The 30 cases of radiation-induced gliomas reported in the English literature are reviewed and analysed. The criteria for defining radiation-induced tumours of the ...

Silicone induced synovitis is a rare, but well reported complication of implant surgery for rheumatoid disease and osteoarthritis (OA). Although familiar to the orthopedists and particularly the hand surgeons, this clinical entity deserves greater attention by rheumatologists, in view of the increasing frequency of small joint replacement. Our report documents ...

Three cases of leucoencephalopathy induced by carmofur (1-hexylcarbamoyl-5-fluorouracil), an antineoplastic derivative of 5-fluorouracil are reported and the literature is reviewed. Initial symptoms were unsteady gait and dementia developing several weeks or months after carmofur had been started. Symptoms increased gradually even after stopping the drug. Severe encephalopathy with confusion, delirium ...

There is a popular consensus in the medical profession and the laity that spontaneous and induced abortions have few psychologic sequelae. A review of the literature reveals that this is not true; the incidence of symptoms ranges from 7% to 41%. Even when symptoms occur, they are said to be ...

We report the case of a patient with carbamazepine-induced cholestasis in whom histologic examination showed acute cholangitis. This type of lesion broadens the spectrum of carbamazepine-induced liver injury which also includes granuloma and hepatocellular necrosis. Its association with marked hypereosinophilia suggests that carbamazepine may cause acute cholangitis through an immunoallergic ...

Seven patients suffering from amiodarone-induced pneumonitis were followed after diagnosis over a period of 16 +/- 6 months. All of them showed clinical, radiographic and functional manifestations of interstitial lung disease. Bronchoalveolar lavage was performed on 6 of them and disclosed lymphocytosis in 2 cases (associated to eosinophilia in 1 ...

This case report describes a 63 year old woman with a nineteen year history of Huntington's Chorea who had been successfully treated with tetrabenazine for 9 years. During a hospital admission for an unrelated medical illness, she was given two doses of chlorpromazine 25 mg for a vascular headache and ...

Severe bronchospasm occurring after extracorporeal circulation is an unusual event. We report three such cases. Possible etiologies include activation of complement anaphylatoxins during cardiopulmonary bypass, cardiac asthma, cold urticaria syndrome, exacerbation of preoperative bronchospastic disease, allergic reactions, drug-induced histamine release and beta-adrenergic blockade induced bronchospasm. The management and treatment of ...

Data from a case-control study of miscarriages (spontaneous abortions) were used to test whether single and multiple induced abortions are associated with miscarriage in subsequent euploid (chromosomally normal) pregnancies. Cases and controls were identified in three New York City hospitals between April 1974 and November 1982. It was hypothesized that, ...

A young, healthy woman underwent craniotomy for the resection of a corpus callosum arteriovenous malformation. She was slow to awaken from anesthesia and was later noted to have a total external ophthalmoplegia. Her mental status quickly improved but the total ophthalmoplegia showed only minimal improvement for 2 weeks. After ruling ...

A 77-year-old patient is described who developed pemphigus vulgaris temporally with the administration of cefadroxil. The disease improved when the drug was discontinued but was exacerbated with the administration of ampicillin. This may be the first case of possible cefadroxil-induced and only the second case of ampicillin-induced pemphigus vulgaris reported. ...

Five cases of amiodarone-induced syncope due to torsades de pointes or ventricular fibrillation are described. Amiodarone was used for recurrent supraventricular tachycardia in four cases and frequent ventricular extra systoles complicating congenital QT prolongation in the remaining case. Each was associated with a marked prolongation in the QTc interval following ...

A three-year-old girl presented with perianal bowenoid papulosis that was presumed to be induced by sexual contact. The lesion was treated by biopsy only and regressed over 8 months without further therapy. The importance of this case with respect to the viral cause, venereal transmission, and spontaneous regression is discussed. ...

We report a case of nonfatal complete atrio-ventricular (A-V) block after injection of 125 mg of furosemide by a central vena cava catheter. Accidents with this diuretic are very rare but this observation shows that it could induce A-V conduction disturbances. When large quantities of this diuretic must be used, ...

Fifteen cases of idiopathic VT responsive to verapamil were studied to examine its clinical, electrocardiographic and electrophysiologic features. All patients were male, aged 15-49, average age 28. Initial onset of VT occurred at ages 9-48 (average 21). Time from onset of VT to first admission was 1-20 years (average 8.2 ...

Renal failure is a rare complication associated with the use of rifampicin for the treatment of tuberculosis, usually occurring well into the course of therapy. The following is a report of 2 cases of rifampicin-induced renal insufficiency. In the first case oligo-anuric renal failure occurred on the thirteenth day of ...

A case report of amoxapine-induced tardive dyskinesia following discontinuation of amoxapine therapy is reported. During 68 weeks of therapy, the patient received a maximum of amoxapine 400 mg/d. Six months after amoxapine discontinuation, the patient continued to have symptoms of tardive dyskinesia. These symptoms correlate with the dopamine receptor-blocking property ...

We report two cases of serious intracerebral haemorrhage occurring in young women following their first use of oral medications containing catecholaminergic agents (phenylpropanolamine in combination with ephedrine or pseudoephedrine). Both women were previously well, and there was no evidence for systemic vasculitis, coagulopathy, aneurysm or arteriovenous malformation. Angiography in both ...

D-Penicillamine is able to induce a bullous eruption with the clinical, histological and immunological features of pemphigus. We present a case that had all the characteristics of pemphigus, but also in vivo bound IgG against the dermo-epidermal junction, i.e. the immunological features of bullous pemphigoid. Since no subepidermal blistering was ...

Three cases of D-penicillamine (DPA) induced myasthenia gravis (MG) and one case of DPA-induced polymyositis (PM) are reported among four patients suffering from seropositive rheumatoid arthritis. The cumulative doses responsible for the three DPA-induced MG cases amounted respectively to 73, 117 and 467 g. The cumulative dose responsible for the ...

Postoperative localized alopecia has been reported most commonly after certain gynecologic and open heart surgery procedures, the likelihood of hair loss and the chance of permanence correlating with the length of the anesthesia and the intubation. Some cases of pressure-induced alopecia have been described after prolonged coma from other causes. ...

A review of the world literature until December 1982 revealed 843 cases of sulphonylurea-induced hypoglycaemia (SIH) with a mortality of 9%. There were 42 cases of metformin-associated lactic acidosis (MALA) with 18 deaths (43%); 40 of the MALA cases had documented contra-indications, especially renal impairment, and the remaining two cases ...

Three patients exhibiting recurrent cutaneous eruptions induced by contact with jellyfish tentacles are presented. The recurrent eruptions appeared several days after the primary exposure without contact with any offending coelenterate. The principal species involved include Pelagia noctiluca, Physalia physalis and probably Lychnorhiza lucerna. These three cases, combined with an earlier ...

Hepatotoxicity is a rare complication of treatment with gold salts. The clinical and laboratory features are those of cholestatic jaundice and other diagnostic possibilities must be ruled out. Gradual recovery after withdrawal of the drug is the rule. We report a case and review previous literature with emphasis on the ...

The authors report a consecutive group of 95 patients suffering from chronic ulceration treated by a mixture of Collagenase Clostridiopeptidase A and 1% Chloramphenicol. Some cases involved skin only, some affected skin and muscle, and some also affected bone. The treatment was successful in all cases. The mixture acts by ...

A case of prolonged cholestatic jaundice and leukopenia occurring in a 60 year old wh piroxicam--a non-steroidal antiinflammatory agent--is reported. Histological examination of liver biopsy revealed pronounced canalicular and intracellular bile retention. After discontinuation of the drug serum bilirubin declined to normal values over a period of 10 weeks.

We report a case of urticaria and fixed drug eruption ( FDE ) caused by griseofulvin. Although griseofulvin-induced urticaria is well documented, FDE secondary to griseofulvin is distinctly uncommon. Moreover, the appearance of urticaria and FDE in the same patient following treatment with griseofulvin is, we believe, the first to ...