These patients have moderate eosafegeal symptoms(vomiting, odinofagia) and urticaria.Especially GIS symptoms are prominent.All antibiotics and pain killers, some antiehitamins and steroids. I am going to use metotrexate or ciclosporin. Give me some advise your practide and experinces,please.
Handan,
Are these symptoms present with oral administratio or intravenous (IV) or both?
I have had patients that have allergies to the compounding materials and therefore required IV administration. Just a thought.
Regards,
Christopher
Thanks for your answer Christopher and Janet. Last time, I administered IV clindamicyn during acute cryptic tonsillitis, first dose was been tolerated and second-third dose begun easefageal dismotility and severe nausea. I gave rupatadine tb PO second dose led to same symptoms. IV difenhiramine is good, no symptoms, allergy is regressing.I can try probiotics. thanks
Firstly you need to exclude an eosinophilic esophagitis or other gastroenteric diseases, then make a differential diagnosis between a multiple drug hypersensitivity syndrome and a multiple drug intolerance syndrome (the latter is linked to a high psychiatric reactive status with subjective symptoms such as discomfort, weakness, itching, headache, stomachache and sometimes vocal cord dysfunction, ecc).Yet study the composition of all the drug assumed by patients with their personal formulations to exclude a common cuprit excipient and lastly make a confront on Wikipedia of all the chemical formula of drugs inducing hypersensitivity to identify shared similar chemical groups. I know it is a hard job but in most cases it works
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