Rash Evaluation in a Transplant Patient.

IF 1.1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Annals of clinical and laboratory science Pub Date : 2024-09-01
Sarah Shidid, Ananna Kazi, Golda Hudes, Tamar Smith-Norowitz
{"title":"Rash Evaluation in a Transplant Patient.","authors":"Sarah Shidid, Ananna Kazi, Golda Hudes, Tamar Smith-Norowitz","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To present the case of a solid organ transplant recipient with a rash, which might be a drug allergy mimic.</p><p><strong>Case report: </strong>We present a 62-year-old male lung transplant recipient, who experienced a sudden erythematous rash two months post-transplant after he was given new medications for his transplant status. Physical examination by the team revealed the patient had a generalized flat, polymorphic papular rash with pinpoint crusting and associated excoriations. Skin biopsy indicated purpuric interface dermatitis with eosinophils, which suggested a drug reaction. In the workup process, patient was admitted for Rhinovirus (HRV) infection and placed on 30 mg prednisone tapering. His rash slowly resolved with discontinuation of Bactrim and Voriconazole. His overall clinical picture was concerning for a drug allergy, but he was on high-dose systemic corticosteroid regimen (Prednisone 40 mg daily) which hindered drug allergy testing.</p><p><strong>Conclusion: </strong>Findings suggest a potential drug allergy or drug reaction, but workup was limited. Thus, the consulting clinician could consider this case a drug allergy mimic or should consider other medical conditions. Challenges exist in identifying a correct differential diagnosis of drug allergy in clinically complicated transplant patients; misdiagnosis may occur, which might lead to delayed care. There is a need for alternative differential diagnostic strategies and treatment options.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"54 5","pages":"685-687"},"PeriodicalIF":1.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of clinical and laboratory science","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To present the case of a solid organ transplant recipient with a rash, which might be a drug allergy mimic.

Case report: We present a 62-year-old male lung transplant recipient, who experienced a sudden erythematous rash two months post-transplant after he was given new medications for his transplant status. Physical examination by the team revealed the patient had a generalized flat, polymorphic papular rash with pinpoint crusting and associated excoriations. Skin biopsy indicated purpuric interface dermatitis with eosinophils, which suggested a drug reaction. In the workup process, patient was admitted for Rhinovirus (HRV) infection and placed on 30 mg prednisone tapering. His rash slowly resolved with discontinuation of Bactrim and Voriconazole. His overall clinical picture was concerning for a drug allergy, but he was on high-dose systemic corticosteroid regimen (Prednisone 40 mg daily) which hindered drug allergy testing.

Conclusion: Findings suggest a potential drug allergy or drug reaction, but workup was limited. Thus, the consulting clinician could consider this case a drug allergy mimic or should consider other medical conditions. Challenges exist in identifying a correct differential diagnosis of drug allergy in clinically complicated transplant patients; misdiagnosis may occur, which might lead to delayed care. There is a need for alternative differential diagnostic strategies and treatment options.

分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
移植患者皮疹评估
病例报告介绍一例实体器官移植受者的皮疹病例,该病例可能是药物过敏的模拟病例:我们报告的是一名 62 岁的男性肺移植受者,他在移植后两个月因移植状态而服用新药后突然出现红斑皮疹。医疗小组的体格检查显示,患者全身出现扁平、多形性丘疹,伴有针尖大小的结痂和相关的溃疡。皮肤活检显示,患者患有紫癜性界面皮炎,伴有嗜酸性粒细胞,这表明患者出现了药物反应。在检查过程中,患者因鼻炎病毒(HRV)感染入院,并开始服用 30 毫克泼尼松。停用 Bactrim 和 Voriconazole 后,皮疹慢慢消退。他的整体临床表现与药物过敏有关,但他正在接受大剂量全身皮质类固醇治疗(泼尼松每天 40 毫克),这阻碍了药物过敏测试:结论:研究结果表明可能存在药物过敏或药物反应,但检查结果有限。因此,临床会诊医生可将此病例视为药物过敏模拟病例,或应考虑其他病症。对临床复杂的移植患者进行正确的药物过敏鉴别诊断存在挑战;可能会出现误诊,从而导致治疗延误。有必要制定其他鉴别诊断策略和治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Annals of clinical and laboratory science
Annals of clinical and laboratory science 医学-医学实验技术
CiteScore
1.60
自引率
0.00%
发文量
112
审稿时长
6-12 weeks
期刊介绍: The Annals of Clinical & Laboratory Science welcomes manuscripts that report research in clinical science, including pathology, clinical chemistry, biotechnology, molecular biology, cytogenetics, microbiology, immunology, hematology, transfusion medicine, organ and tissue transplantation, therapeutics, toxicology, and clinical informatics.
期刊最新文献
Communication: 4-Hydroxynonenal and Fracture Risk in the Community-Dwelling Older People. Letter to the Editor. Evaluation of Swab: Direct Extraction Kit, Comparing with AdvanSure E3 System for Nucleic Acid Extraction in Identification of SARS-CoV-2. A Case of Hb Phnom Penh Showing Different HbA1c Levels Depending on the High-Performance Liquid Chromatography System. Application of IdyllaTM System for Rapid Evaluation of EGFR Mutation Status in Formalin-Fixed and Paraffin-Embedded Samples of Non-Small Cell Lung Cancer. Biomarkers Identification of Early Rheumatoid Arthritis via Bioinformatics Approach and Experimental Verification.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1