Document Detail


Kaposi's sarcoma after long-acting steroids: time until remission and drug washout.
MedLine Citation:
PMID:  20110636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Long-acting steroids (LAS) are widely used to treat various inflammatory diseases and allergies. They have many adverse effects including the inhibition of the hypothalamopituitary axis that can last several months. LAS are also strong immunosuppressors and can result in severe opportunistic infections and immunodeficiency-related malignancies. However, the time needed for immune recovery after withdrawal of LAS is unknown. Here we report a case of Kaposi's sarcoma (KS) and severe immunosuppression after a chronic triamcinolone acetonide (TA) treatment. Six months after withdrawal, traces of TA were still detected in the serum by HPLC mass spectrometry. At 8 months, the drug became undetectable, and clinical and biological signs of immune recovery - beginning of KS regression, normalization of IgG levels and CD4 T lymphocyte counts - became noticeable. We then provide a review of the literature on the time until remission of KS after immunosuppression reduction. We also reviewed the cases of KS induced by TA, and the metabolic side effects of TA when compared to standard glucocorticoids.
Authors:
D Nassar; N E C Schartz; C Bouch?; A L?vy; D Kerob; F Agbalika; M Lafaurie; C Lebb?
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2010-01-29
Journal Detail:
Title:  Dermatology (Basel, Switzerland)     Volume:  220     ISSN:  1421-9832     ISO Abbreviation:  Dermatology (Basel)     Publication Date:  2010  
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203244     Medline TA:  Dermatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  159-63     Citation Subset:  IM    
Affiliation:
Department of Dermatology, H?pital Saint-Louis, AP-HP, Paris, France. dany.nassar@inserm.fr
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / administration & dosage,  adverse effects*,  blood
Bleomycin / therapeutic use
Blood Glucose / drug effects
CD4 Lymphocyte Count
Humans
Immunoglobulin G / blood
Immunosuppression / adverse effects*
Insulin / therapeutic use
Interferon-alpha / therapeutic use
Male
Middle Aged
Opportunistic Infections / immunology*,  pathology
Paclitaxel / therapeutic use
Sarcoma, Kaposi / immunology*,  pathology
Skin Ulcer / chemically induced,  immunology
Triamcinolone Acetonide / administration & dosage,  adverse effects*,  blood
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Blood Glucose; 0/Immunoglobulin G; 0/Interferon-alpha; 11056-06-7/Bleomycin; 11061-68-0/Insulin; 33069-62-4/Paclitaxel; 76-25-5/Triamcinolone Acetonide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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