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Multiple Drug Intolerance Syndrome: An Underreported Distinct Clinical Entity

[ Vol. 14 , Issue. 2 ]

Author(s):

Sapan K. Behera, Saibal Das, Kavadichanda G. Chengappa, Alphienes S. Xavier and Sandhiya Selvarajan * Pages 84-90 (7)

Abstract:


Aim: Multiple drug intolerance syndrome (MDIS) is a unique clinical entity distinct from other drug hypersensitivity syndromes. The aim of this review was to critically appraise the various aspects of MDIS.

Methods: A review was conducted to search for the causes, mechanism, clinical features, and management of MDIS.

Results: The most common cause of MDIS is antibiotics followed by non-steroidal antiinflammatory drugs (NSAIDs). Although some non-specific immunological mechanisms are involved, the immunological tests for MDIS are negative. Rashes, gastrointestinal reflux, headache, cough, muscle ache, fever, dermatitis, hypertension, and psychiatric symptoms are the usual manifestations. Treatment is mostly symptomatic with the withdrawal of the offending drug. Drug rechallenges and desensitization may be required for the management of this syndrome.

Conclusion: MDIS occurs by a nonimmune mechanism which requires a prompt withdrawal of the offending drug(s), and in some cases may require drug re-challenge and desensitization.

Keywords:

Multiple drug intolerance syndrome, antibiotics, hypersensitivity, immunological reactions, floctafenine, pyrazolones.

Affiliation:

Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, (JIPMER), Puducherry, Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, (JIPMER), Puducherry, Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, Department of Pharmacology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, (JIPMER), Puducherry

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