ajmaline and Drug-Hypersensitivity

Topics: Administration, Oral; Ajmaline; Arrhythmias, Cardiac; Atrial Fibrillation; Biotransformation; Cardiac Complexes, Premature; Drug Hypersensitivity; Heart; Heart Conduction System; Humans; Hypotension; Injections, Intramuscular; Injections, Intravenous; Tachycardia, Paroxysmal

A 75 year old man, treated with ajmaline, was admitted with malaise, fever, acute renal failure and cholestatic jaundice. Haemolytic anaemia and thrombocytopaenia were also found with a positive indirect Coomb's test in the presence of ajmaline. The immunological and haematological data are discussed in the light of previously published cases.

Topics: Aged; Ajmaline; Anemia, Hemolytic; Anuria; Cholestasis; Drug Hypersensitivity; Humans; Male; Thrombocytopenia

In a 32-year old woman under ajmaline therapy for cardiac arrhythmia, a sudden episode of acute haemolytic anaemia and renal failure led to the identification of a potent agglutinating, haemolysing and lymphocytotoxic antibody specific to ajmaline and cross-reacting with quinine and quinidine. The immunological features of the antibody and the pathophysiological mechanism of blood cell destruction are presented, together with a brief synopsis of drugs incriminated so far in the induction of specific antibody formation and immune haemolytic anaemia.

Topics: Acute Kidney Injury; Adult; Ajmaline; Anemia, Hemolytic; Antibodies; Cytotoxicity, Immunologic; Drug Hypersensitivity; Female; Humans

Topics: Aged; Ajmaline; Arrhythmias, Cardiac; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Drug Hypersensitivity; gamma-Glutamyltransferase; Humans; Liver Diseases; Male; Transaminases

Topics: Aged; Ajmaline; Anuria; Drug Hypersensitivity; Humans; Jaundice; Male; Thrombocytopenia

A report is given on a patient in whom during treatment and prophylactic measures of paroxysmal tachycardias after intravenous application of ajmalin large attacks of fever with chills developed. The oral application evoked subfebrile temperatures and weakness. The drug-fever which was to be ascertained by exposition and omitting experiments was falsely explained for many years.

Topics: Ajmaline; Allergens; Diagnostic Errors; Drug Hypersensitivity; Fever; Haptens; Humans; Male; Middle Aged; Shivering; Tachycardia

Topics: Aged; Ajmaline; Aniline Compounds; Arrhythmias, Cardiac; Benzyl Compounds; Bone Marrow Examination; Cell Survival; Chromium Radioisotopes; Clot Retraction; Digoxin; Drug Combinations; Drug Hypersensitivity; Ethylenediamines; Histocytochemistry; Humans; Imidazoles; Male; Megakaryocytes; Phenobarbital; Sparteine; Thrombocytopenia