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Adverse effects include nasopharyngitis, headache, elevated serum pancreatic enzymes, and gastrointestinal symptoms. In addition, a few cases of interstitial pneumonia associated with their use have been reported in the Japanese literature.

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Here we describe a patient who developed drug- induced acute lung injury shortly after the administration of the dipeptidyl peptidase-4 inhibitor vildagliptin. A year-old Japanese woman with diabetes mellitus developed acute respiratory failure 1 day after administration of vildagliptin.

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Chest computed tomography revealed nonsegmental ground-glass opacities in her lungs. There was no evidence of bacterial pneumonia or any other cause of her respiratory manifestations. After discontinuation of vildagliptin, she recovered fully from her respiratory disorder.

She received insulin therapy for her diabetes mellitus, and her subsequent clinical course has been uneventful. The period of drug exposure in previously reported cases of patients with drug- induced interstitial pneumonia caused by dipeptidyl peptidase-4 inhibitor varied from several days to over 6 months.

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In the present case, our patient developed interstitial pneumonia only 1 day after the administration of vildagliptin. The precise mechanism of her vildagliptin- induced lung injury remains uncertain, but physicians should consider that dipeptidyl peptidase-4 inhibitor- induced lung injury, although rare, may appear acutely , even within days after administration of this drug. Induced hypernatraemia is protective in acute lung injury.

Sucrose induced hyperosmolarity is lung protective but the safety of administering hyperosmolar sucrose in patients is unknown.

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Hypertonic saline is commonly used to produce hyperosmolarity aimed at reducing intra cranial pressure in patients with intracranial pathology. During 2h of non-injurious mechanical ventilation parameters of acute lung injury were assessed. Independent of fluid or sodium load, induced hypernatraemia is lung protective in lipopolysaccharide- induced acute lung injury.

Full Text Available A year-old male was sent to the emergency room due to a high fever and generalized skin rash after taking allopurinol for 9 days.

Physical examination was normal except for the generalized skin rash presenting with erythematous macules. Complete blood count showed leukocytosis with eosinophilia. Blood biochemistry showed impaired renal and hepatic function. Pathologic examination concluded that the skin rash was erythema multiforme. These findings met the diagnostic criteria for allopurinol- induced hypersensitivity syndrome AHS.

Our patient not only had the most common skin lesion but soon developed acute renal failure that required intermittent hemodialysis, despite rapid discontinuation of allopurinol and adequate hydration and steroid therapy. No other causes of acute renal failure were found.

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Renal impairment was the worst part of the patient's condition and he never completely recovered. AHS should be considered in the differential diagnosis of acute renal and hepatic failure in patients with evidence of allergy and recent use of allopurinol. Kruize, A. The design of. Effect of disease stage on progression of hydroxychloroquine retinopathy.

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Hydroxychloroquine sulfate retinopathy can progress after the drug is stopped. It is not clear how this relates to the stage of retinopathy or whether early screening with modern imaging technology can prevent progression and visual loss. To determine the relationship between progression of retinopathy and the severity of disease using objective data from optical coherence tomography and assess the value of early screening for the toxic effects of hydroxychloroquine. Clinical findings in patients with hydroxychloroquine retinopathy were monitored with repeated anatomical and functional examinations for 13 to 40 months after the drug was stopped in a referral practice in a university medical center.

Visual acuity, white visual field pattern density plots, fundus autofluorescence, spectral-density optical coherence tomography cross sections, thickness from cube diagrams , and ellipsoid zone length. Visual acuity and visual fields showed no consistent change. Fundus autofluorescence showed little or no change except in severe cases in which the bull's-eye damage expanded progressively. A few cases showed a suggestion of ellipsoid zone improvement. Patients with.

Cannabis is the most frequently consumed illicit drug in the world, with higher prevalence under the age of 35 years. Cannabis was first reported as a possible cause of acute pancreatitis AP in The aim of this systematic review is to examine cannabis use as an etiology of AP. Search terms were "Cannabis" and " Acute Pancreatitis" with all permutations. The search yielded results. Acute pancreatitis was defined by meeting 2 of 3 Revised Atlanta Classification criteria.

Cannabis- induced AP was defined by preceding use of cannabis and exclusion of common causes of AP when reported. Sixteen papers met inclusion criteria dating from to Acute pancreatitis correlated with increased cannabis use in 18 patients. Recurrent AP related temporally to cannabis use was reported in 15 of There are 13 reports of no further AP episodes after cannabis cessation. Cannabis is a possible risk factor for AP and recurrent AP, occurring primarily in young patients under the age of 35 years.

Toxicology screens should be considered in all patients with idiopathic AP. Prophylactic use of octreotide for asparaginase- induced acute pancreatitis. In the present study, we sought to evaluate the prophylactic use of octreotide for asparaginase- induced acute pancreatitis. We reviewed the medical records of seven patients in two institutions who received prophylactic octreotide for re-administration of asparaginase after asparaginase- induced acute pancreatitis.

Three patients completed asparaginase treatment without developing pancreatitis, and four experienced recurrence of pancreatitis. A literature search using PubMed identified four additional patients in whom asparaginase was successfully re-administered with octreotide.

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Prophylactic use of octreotide may, thus, be warranted for patients who would benefit from re-administration of asparaginase for cancer treatment; however, careful observation is needed to monitor for breakthrough recurrence of pancreatitis. Full Text Available Endothelin receptor antagonists are commonly used in the treatment of pulmonary hypertension.

A case involving a year-old female with sitaxsentan- induced acute severe liver failure is presented. Depite withdrawal of therapy, her liver tests failed to improve. After six weeks of monitoring, the patient was administered high-dose corticosteroids, with a good clinical and biochemical response. While endothelin receptor antagonists are postulated to cause hepatitis by inhibition of a bile salt transporter pump, an immune-mediated or idiosyncratic mechanism should be considered. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis.

Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction AMI. Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in res Mechanisms of bee venom- induced acute renal failure. The spread of Africanized bees in the American continent has increased the number of severe envenomation after swarm attacks. Acute renal failure ARF is one of the major hazards in surviving patients.

To assess the mechanisms of bee venom- induced ARF, rats were evaluated before, up to 70 min and 24h after 0. Control rats received saline. Bee venom caused an early and significant reduction in glomerular filtration rate GFR, inulin clearance, 0. Full Text Available Cardiovascular disease is the largest cause of morbidity and mortality among patients with chronic kidney disease CKD and end-stage kidney disease, with nearly half of all deaths attributed to cardiovascular disease. Hydroxychloroquine HCQ, an anti-inflammatory drug, has been shown to have multiple pleiotropic actions relevant to atherosclerosis.

We conducted a proof-of-efficacy study to evaluate the effects of hydroxychloroquine in an animal model of atherosclerosis in ApoE knockout mice with and without chronic kidney disease.

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Forty male, 6-week-old mice were divided into four groups in a 2 x 2 design: sham placebo group; sham treatment group; CKD placebo group; and CKD treatment group. CKD was induced by a two-step surgical procedure. All mice received a high-fat diet through the study duration and were sacrificed after 16 weeks of therapy.

Mice were monitored with ante-mortem ultrasonic echography AUE for atherosclerosis and vascular stiffness and with post-mortem histology studies for atherosclerosis. Additionally, therapy with HCQ resulted in significant reduction in vascular endothelial dysfunction with improvement in vascular elasticity and flow patterns and better-preserved vascular wall thickness across multiple vascular beds.