Clopidogrel, an adenosine diphosphate receptor blocker, is widely used as an adjunctive antiplatelet therapy in acute coronary syndrome and percutaneous coronary stenting. It appears to be a safe drug with few occurrences of liver side-effects that usually resolved after drug withdrawal. We report a serious liver injury with fatal outcome in a 63-year-old man developed 19 days after starting clopidogrel for percutaneous coronary stenting.
As the COVID‐19 vaccination campaign progresses worldwide, Guillain–Barré syndrome (GBS) vaccine‐related cases have been reported. We carried out a retrospective, descriptive study of GBS patients following COVID‐19 vaccine, submitted to the National Pharmacovigilance Center of Tunis during the period between March 2021 and May 2022. Our study aimed to identify epidemiological and clinical features of COVID‐19 vaccine‐associated GBS. We found 9 cases of GBS post COVID‐19 vaccination; 5 of them were excluded due to the lack of information, whereas 4 cases were included in this study. Men represented 75% (3/4) of the cases. The most frequently reported vaccine type was ChAdOx1 nCoV‐19 vaccine (n = 2 reports [50%]), Ad26.COV2.S vaccine and BNT162b2 vaccine in 1. The mean time interval from vaccination to symptom onset was 15.3 days. Clinical manifestations were different: classical GBS in two cases and GBS with unilateral facial palsy in the other 2 cases. All patients were treated with a course of intravenous immunoglobulin for 5 days. Three patients reported clinical improvement while one case (25%) showed treatment‐related fluctuations. Our observations suggest that COVID‐19 vaccines may be associated with GBS. Continuous surveillance and further studies are warranted to assess the significance of the association.
Introduction:
Liposomal amphotericin B is a widely used broad-spectrum antifungal drug. It was developed to reduce nephrotoxicity and maximize the therapeutic utility of amphotericin B in the treatment of invasive fungal infections. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity syndrome commonly associated with aromatic antiepileptic drugs. Liposomal amphotericin-B was associated with DRESS syndrome in only one case.
Case Report:
We report an exceptional case of possible DRESS syndrome associated with Liposomal amphotericin B in a 31-year-old male, renal transplant recipient. Seventeen days after starting Liposomal amphotericin B for visceral leishmaniosis, he developed a skin rash, with elevated liver tests. Liposomal amphotericin B was discontinued. A favourable outcome was slowly observed in one month.
Results and Conclusion:
This case was scored two (possible case) based on the criteria adopted by the European group RegiSCAR. The Naranjo score for Liposomal amphotericin B was four (possible).
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