A 70-year-old male exhibiting parkinsonism-hyperpyrexia syndrome during levodopa carbidopa intestinal gel (LCIG) treatment and suspected carbidopa allergy due to positive drug-induced lymphocyte stimulation test (DLST)

A 70-year-old male who has medical history of Parkinson's disease for 26 years admitted to our hospital for trial of levodopa carbidopa intestinal gel (LCIG) therapy because of severe dyskinesia and frequent wearing-off. He developed deterioration when he was treated with one of the levodopa (LD) decacrboxylase inhibitor compounds in the past. Five days after LD had changed into equivalent dose of LD/carbidopa (CD), high fever with hyperCKemia appeared. He was diagnosed as having Parkinsonism-hyperpyrexia syndrome (PHS). Exchange of LD/CD to LD drugs improved the symptoms quickly. Four days after LCIG administration, PHS reappeared. Simultaneously, the patient developed sepsis and disseminated intravascular coagulation (DIC). Thrombocytopenia did not improve after recovery from infection and DIC. Anti-PA IgG and drug-induced lymphocyte stimulation test (DLST) against LCIG showed positive. Exchange of LCIG to LD drugs and intravenous methylprednisolone administration improved the symptoms and thrombocytopenia. CD induced type II and type IV allergy were suspected. This case offers a caution that physicians should be aware of drug allergy in cases of which unexpected symptoms occurred in altering one LD compound to another.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:64

Enthalten in:

Rinsho shinkeigaku = Clinical neurology - 64(2024), 1 vom: 20. Jan., Seite 17-22

Sprache:

Japanisch

Beteiligte Personen:

Kawanami, Aya [VerfasserIn]
Miyashita, Masanobu [VerfasserIn]
Miyagi, Yuichi [VerfasserIn]
Hasegawa, Kazuko [VerfasserIn]

Links:

Volltext

Themen:

46627O600J
Antiparkinson Agents
Carbidopa
Case Reports
Disseminated intravascular coagulation
Drug Combinations
Drug allergy
English Abstract
Journal Article
Levodopa
Levodopa carbidopa continuous infusion gel therapy
Levodopa carbidopa intestinal gel
MNX7R8C5VO
Parkinsonism-hyperpyrexia syndrome

Anmerkungen:

Date Completed 23.01.2024

Date Revised 23.01.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.5692/clinicalneurol.cn-001883

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365831182