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Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction

The fixed drug eruption is a non-immediate hypersensitivity reaction to drug, characterized by recurrent erythematous or violaceous, rounded, well-defined border plaques, which always appear in the same location every time the culprit drug is administered. The usual practice is to avoid the drug inv...

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Autores principales: Pereira, Amanda Rocha Firmino, Aun, Marcelo Vivolo, Kelmann, Nathália Coelho Portilho, Motta, Antônio Abílio, Kalil, Jorge, Giavina-Bianchi, Pedro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896605/
https://www.ncbi.nlm.nih.gov/pubmed/31778467
http://dx.doi.org/10.31744/einstein_journal/2020RC5002
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author Pereira, Amanda Rocha Firmino
Aun, Marcelo Vivolo
Kelmann, Nathália Coelho Portilho
Motta, Antônio Abílio
Kalil, Jorge
Giavina-Bianchi, Pedro
author_facet Pereira, Amanda Rocha Firmino
Aun, Marcelo Vivolo
Kelmann, Nathália Coelho Portilho
Motta, Antônio Abílio
Kalil, Jorge
Giavina-Bianchi, Pedro
author_sort Pereira, Amanda Rocha Firmino
collection PubMed
description The fixed drug eruption is a non-immediate hypersensitivity reaction to drug, characterized by recurrent erythematous or violaceous, rounded, well-defined border plaques, which always appear in the same location every time the culprit drug is administered. The usual practice is to avoid the drug involved and to use a structurally different drug. However, there are situations in which there is no safe and effective therapy. In such situations, desensitization is the only option. We describe the case of a patient who presented fixed eruption due to sulfamethoxazole-trimethoprim, who underwent successful desensitization, but required a repeat procedure twice due to relapse after inadvertent full-dose reintroduction. In non-immediate hypersensitivity reaction to drug, the indication is controversial and there is no technical standardization. Furthermore, the time at which such tolerance is lost after discontinuing the drug involved is unknown. In severe non-immediate reactions of types II and III, desensitization is contraindicated. The patient underwent desensitisation to sulfamethoxazole-trimethoprim three times − the first with recurrence of lesions and the second and third without manifestations, all concluded successfully and with no premedication.
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spelling pubmed-68966052019-12-24 Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction Pereira, Amanda Rocha Firmino Aun, Marcelo Vivolo Kelmann, Nathália Coelho Portilho Motta, Antônio Abílio Kalil, Jorge Giavina-Bianchi, Pedro Einstein (Sao Paulo) Case Report The fixed drug eruption is a non-immediate hypersensitivity reaction to drug, characterized by recurrent erythematous or violaceous, rounded, well-defined border plaques, which always appear in the same location every time the culprit drug is administered. The usual practice is to avoid the drug involved and to use a structurally different drug. However, there are situations in which there is no safe and effective therapy. In such situations, desensitization is the only option. We describe the case of a patient who presented fixed eruption due to sulfamethoxazole-trimethoprim, who underwent successful desensitization, but required a repeat procedure twice due to relapse after inadvertent full-dose reintroduction. In non-immediate hypersensitivity reaction to drug, the indication is controversial and there is no technical standardization. Furthermore, the time at which such tolerance is lost after discontinuing the drug involved is unknown. In severe non-immediate reactions of types II and III, desensitization is contraindicated. The patient underwent desensitisation to sulfamethoxazole-trimethoprim three times − the first with recurrence of lesions and the second and third without manifestations, all concluded successfully and with no premedication. Instituto Israelita de Ensino e Pesquisa Albert Einstein 2019-11-14 /pmc/articles/PMC6896605/ /pubmed/31778467 http://dx.doi.org/10.31744/einstein_journal/2020RC5002 Text en http://creativecommons.org/licenses/by/4.0/ This content is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Case Report
Pereira, Amanda Rocha Firmino
Aun, Marcelo Vivolo
Kelmann, Nathália Coelho Portilho
Motta, Antônio Abílio
Kalil, Jorge
Giavina-Bianchi, Pedro
Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction
title Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction
title_full Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction
title_fullStr Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction
title_full_unstemmed Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction
title_short Loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction
title_sort loss of tolerance 5 days after discontinuing sulphonamide introduced via desensitization in delayed reaction
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896605/
https://www.ncbi.nlm.nih.gov/pubmed/31778467
http://dx.doi.org/10.31744/einstein_journal/2020RC5002
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