Drug Hypersensitivity Syndrome Induced by Meglumine Antimoniate

Fakhri Jeddi Service de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Eric Caumes Service de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Marc Thellier Service de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Stéphane Jauréguiberry Service de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Dominique Mazier Service de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Pierre A. Buffet Service de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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We report a case of drug hypersensitivity syndrome (drug reaction with eosinophilia and systemic symptoms [DRESS]) induced by parenteral meglumine antimoniate (Glucantime) in a 40-year-old man who traveled to Bolivia and was treated for mucocutaneous leishmaniasis. Two weeks after starting therapy, the patient had fever, joint pain, a cutaneous eruption, and hypereosinophilia (1,358 cells/mm3). These symptoms resolved after drug withdrawal but reappeared upon reintroduction of the drug. Pentavalent antimonials should be definitively withdrawn in patients with hypereosinophilia > 1,000 cells/mm3 accompanied by systemic manifestations consistent with DRESS.

Author Notes

  • 1

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  • 2

    Masmoudi A, Maalej N, Mseddi M, Souissi A, Turki H, Boudaya S, Bouassida S, Zahaf A, 2005. Glucantime ® par voie parentérale: bénéfice versus toxicité. Med Mal Infect 35 :42–45.

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  • 3

    Oliveira MC, Amorim RF, Freitas Rde A, Costa Ade L, 2005. A fatal case of mucocutaneous leishmaniasis after pentavalent antimonial use. Rev Soc Bras Med Trop 38 :258–260.

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  • 4

    Lambertucci JR, França BM, Queiroz Ede M, 2004. Acute pancreatitis caused by meglumine antimoniate given for the treatment of visceral leishmaniasis. Rev Soc Bras Med Trop 37 :74–75.

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  • 5

    Bocquet H, Bagot M, Roujeau JC, 1996. Drug-induced pseudo-lymphoma and drug hypersensitivity syndrome (drug rash with eosinophilia and systemic symptoms: DRESS). Semin Cutan Med Surg 15 :250–257.

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  • 6

    Roujeau JC, 2005. Clinical heterogenicity of drug hypersensitivity. Toxicology 209 :123–129.

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    Tas S, Simonart T, 2003. Management of drug rash with eosinophilia and systemic symptoms (DRESS syndrome): an update. Dermatology 206 :353–356.

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    Lee JH, Park HK, Heo J, Kim TO, Kim GH, Kang DH, Song GA, Cho M, Kim DS, Kim HW, Lee CH, 2008. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome induced by celecoxib and anti-tuberculosis drugs. J Korean Med Sci 23 :521–525.

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  • 9

    Zuliani E, Zwahlen H, Gilliet F, Marone C, 2005. Vancomycin-induced hypersensitivity reaction with acute renal failure: resolution following cyclosporine treatment. Clin Nephrol 64 :155–158.

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  • 10

    de Lima MV, Oliveira RZ, de Lima AP, Felix ML, Silveira TG, Rossi RM, Teodoro U, 2007. Atendimento de pacientes com leishmaniose tegumentar americana: avaliação nos services de saúde de municípios do nordeste do Estado do Paraná, Brasil. Cad Saude Publica 23 :2938–2948.

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  • 11

    Hotez PJ, Brindley PJ, Bethony JM, King CH, Pearce EJ, Jacobson J, 2007. Helminth infections: the great neglected tropical diseases. J Clin Invest 118 :1311–1321.

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