Multiple Drug Intolerance Syndrome: An Underreported Distinct Clinical Entity

Author(s): Sapan K. Behera, Saibal Das, Kavadichanda G. Chengappa, Alphienes S. Xavier, Sandhiya Selvarajan*

Journal Name: Current Clinical Pharmacology

Volume 14 , Issue 2 , 2019

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Graphical Abstract:


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.

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Article Details

VOLUME: 14
ISSUE: 2
Year: 2019
Page: [84 - 90]
Pages: 7
DOI: 10.2174/1574884713666181112125714

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