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  • 1
    Electronic Resource
    Electronic Resource
    Hypersensitivitätssyndrom durch Antikonvulsiva (1997)
    Springer
    Monatsschrift Kinderheilkunde 145 (1997), S. 109-113 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Carbamazepin ; Hypersensitivitätssyndrom ; Fieber ; Exanthem ; Lymphadenopathie ; Key words Carbamazepine ; Hypersensitivity syndrome ; Fever ; Skin rash ; Lymphadenopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary 2 weeks after initiation of carbamazepine therapy a 3 year old boy presented with skin rash, fever, lymphadenopathy, hepatosplenomegaly and nephritis. After exclusion of infectious diseases our differential diagnosis focussed on carbamazepine induced hypersensitivity syndrome. We found a positive lymphocyte transformation assay and patch test to carbamazepine, indicating a specific response, but no anti-carbamazepine antibody, no circulating immune complexes and no decrease in complement components. The hypersensitivity syndrome refers to a severe hypersensitivity response due to a idiosyncratic reaction. The origin is unknown. The similarity to other multisystem disorders is discussed. Discussion: Not only aromatic antiepileptic agents (carbamazepine, phenobarbital, phenytoin) sulfonamides but as well allopurinol and gold salts are associated with the syndrome. Withdrawal of the drug and treatment with corticosteroids usually lead to complete recovery.
    Notes: Zusammenfassung Wir berichten über einen 3 jährigen Jungen, der 2 Wochen nach Beginn einer antiepileptischen Behandlung an einem Carbamazepin-induzierten Hypersensitivitätssyndrom, bestehend aus therapieresistentem Fieber, polymorphem Exanthem, oropharyngealen Läsionen, generalisierter Lymphadenopathie, Hepatosplenomegalie und Nephritis, erkrankte. Wir fanden positive Lymphozytenstimulations- und Epikutantests auf Carbamazepin als Ausdruck einer spezifischen Überempfindlichkeit. Spezifische Anti-Carbamazepin-Antikörper, zirkulierende Immunkomplexe oder eine Komplementerniedrigung waren nicht nachweisbar. Es handelt sich um eine Überempfindlichkeitsreaktion unbekannter Ätiologie im Sinn einer Idiosynkrasie. Nach Ausschluß infektiöser Ursachen wird die Differentialdiagnose zu anderen Systemerkrankungen erörtert. Diskussion: Neben aromatischen Antikonvulsiva (Carbamazepin, Phenobarbital, Phenytoin) sind Sulfonamide und Goldsalze mögliche Auslöser eines Hypersensitivitätssyndroms. Absetzen des Induktors und systemische Kortikosteroide führen in der Regel zur vollständigen Remission.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050110
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Measurement of respiratory mechanics in paediatric intensive care: in vitro assessment of a pulmonary function device (1998)
    Springer
    Intensive care medicine 24 (1998), S. 1083-1088 
    Details
    ISSN: 1432-1238
    Keywords: Key words Respiratory mechanics ; Monitor assessment ; Accuracy ; Interobserver agreement ; Ventilated child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate a recently developed and manufactured device for monitoring respiratory parameters in mechanically ventilated children. Design: In vitro study using a lung model. Setting: University paediatric intensive care unit. Material and interventions: Evaluation of the accuracy of volume and pressure measurements, of the determination of respiratory system compliance (10 to 30 ml/cmH2O) and of resistance (20 and 50 cmH2O/l per s) by the inflation technique (volume- and pressure-controlled mode of ventilation); assessment of interobserver agreement for compliance (10, 15 ml/cmH2O) and resistance (20, 50 cmH2O/l per s) determinations (ANOVA, intraclass correlation coefficient). Measurements and results: The accuracy of volume measurements (No. 1 Fleisch pneumotachograph) was ≤ 5 % of true volumes up to 1 l (Flow: 30 l/min) even after the introduction of an endotracheal tube. The accuracy of pressure measurements up to 70 cmH2O was ≤ 2.5 % of the true values. Coefficients of variation of volume and pressure measurements were 〈 2 %. The accuracy of compliance and resistance determinations was, respectively, ≤ 17 and 25 % of the true values. No significant observer effect was found on compliance and resistance determinations. Indeed, mean differences in compliance and resistance determinations by pairs of observers were 〈 1 %. Intraclass correlation coefficients were 〉 0.98. Conclusions: The measuring error of volume, pressure, compliance and resistance determined using this monitoring system seems acceptable for monitoring purpose. Moreover, use of this system by members of the medical team can be recommended since results obtained by observers, even untrained ones, were similar. In vivo evaluation is now needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050720
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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