losartan-potassium and Skin-Diseases

Our patient is a 26-week-old preterm female infant delivered by caesarean section secondary to severe maternal preeclampsia who had been receiving subcutaneous recombinant erythropoietin (r-EPO) for anemia of prematurity. At 8 weeks of age after 8 doses of r-EPO, the infant developed numerous non-blanching erythematous macules and patches located on the back, posterior shoulder, and posterior arms, concerning for late-onset blueberry muffin lesions. Biopsy of the lesions confirmed dermal hematopoiesis. After r-EPO was discontinued all skin lesions gradually resolved over a period of 2 weeks and never recurred.

Topics: Anemia; Dermis; Erythroblasts; Erythropoietin; Female; Fetal Growth Retardation; Hematopoiesis, Extramedullary; Humans; Infant; Infant, Premature; Infant, Premature, Diseases; Intracranial Hemorrhages; Recombinant Proteins; Respiratory Distress Syndrome, Newborn; Skin Diseases

Recombinant erythropoietin is being used in premature population for anemia of prematurity. It is considered very safe in this population, although risks are still being evaluated. We report the first case of dermal erythropoiesis as a side effect of recombinant erythropoietin in an extremely prematurely born infant presenting with late-onset blueberry muffin lesions.

Topics: Erythropoiesis; Erythropoietin; Hematopoiesis, Extramedullary; Humans; Infant, Newborn; Infant, Premature; Male; Recombinant Proteins; Skin Diseases

Topics: Drug Eruptions; Erythropoietin; Granuloma, Pyogenic; Humans; Skin Diseases

Topics: Erythropoietin; Fibrosis; Humans; Kidney Transplantation; Recombinant Proteins; Skin Diseases

Topics: Erythropoietin; Fibrosis; Gadolinium; Humans; Recombinant Proteins; Renal Insufficiency; Skin Diseases

Nephrogenic systemic fibrosis is a rare fibrosing condition that occurs in patients with renal insufficiency. While its histologic characteristics have been well described, the etiology and pathogenesis have not been fully characterized. Several recent studies support the theory that gadolinium-based contrast agents play a causative role in the development of the disease. Erythropoietin therapy and endothelial damage from surgical procedures have also been suggested as potential contributing factors.. This study attempts to help contribute to the understanding of this novel disorder.. We performed a retrospective chart review of 6 patients diagnosed with nephrogenic systemic fibrosis at our institution. Emphasis was placed on identification of potential putative etiologic agents including gadolinium, erythropoietin therapy, and previous surgical procedures.. All patients had documented exposure to gadolinium-based contrast agents. Three of the 6 patients were treated with erythropoietin, and all patients underwent a previous surgical procedure.. This study is limited by its small size; therefore, the findings and results may not be applicable to all patients with this disorder.. Our data suggest that gadolinium plays a primary role in nephrogenic systemic fibrosis and that prior surgery may be a contributory factor.

Topics: Adult; Aged; Contrast Media; Erythropoietin; Female; Fibrosis; Gadolinium; Humans; Male; Middle Aged; Renal Dialysis; Renal Insufficiency; Retrospective Studies; Skin Diseases; Surgical Procedures, Operative

Topics: Adult; Case-Control Studies; Drug Interactions; Erythropoietin; Female; Fibrosis; Gadolinium; Hematinics; Humans; Kidney Failure, Chronic; Male; Middle Aged; Radiopharmaceuticals; Recombinant Proteins; Risk Factors; Skin; Skin Diseases

Iron overload presenting as exacerbation of hepatic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation has not been previously described. We report 6 patients with established hepatic GVHD in whom iron overload (median serum ferritin, 7231 mug/dL; median transferrin saturation, 77%) resulting from a lifetime median of 20 units of packed red blood cell transfusions was manifested by worsening of liver function. Liver biopsies performed in 4 patients confirmed severe iron overload and also hepatic GVHD. Analysis for the C282Y and H63D hemochromatosis gene mutation was negative for the homozygous state in all 6 patients. Erythropoietin-assisted phlebotomy resulted in normalization of liver function at a median of 7 months and of serum ferritin at a median of 11 months. Immunosuppressive therapy was successfully tapered in all 4 patients who completed the phlebotomy program, and this supported the impression that iron overload, rather than GVHD, was the principal cause of liver dysfunction. At a median follow-up of 50 months (range, 18-76 months) from the transplantation and 25 months (range, 5-36 months) from ferritin normalization, all 4 patients require maintenance phlebotomy. We conclude that iron overload can mimic GVHD exacerbation, thus resulting in unnecessary continuation or intensification of immunosuppressive therapy for GVHD, and that maintenance phlebotomy is necessary after successful iron-reduction therapy.

Topics: Adult; Biopsy; Bone Marrow Transplantation; Combined Modality Therapy; Darbepoetin alfa; Diagnosis, Differential; Disease Progression; Epoetin Alfa; Erythrocyte Transfusion; Erythropoietin; Female; Ferritins; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Immunosuppressive Agents; Iron Overload; Liver Diseases; Male; Middle Aged; Pancreatic Diseases; Phlebotomy; Prospective Studies; Recombinant Proteins; Skin Diseases; Transferrin; Transplantation Conditioning; Transplantation, Homologous

Topics: Erythropoietin; Fibrosis; Humans; Recombinant Proteins; Renal Insufficiency; Skin Diseases

Results of CALGB 9741 demonstrated that administering standard doxorubicin/cyclophosphamide (AC)-paclitaxel therapy for adjuvant therapy of breast cancer in a dose-dense fashion with colony-stimulating factors increases efficacy, decreases severe neutropenia, but may increase the need for blood transfusions. A chart review was performed to evaluate the rates of anemia, neutropenia and skin toxicities with dose-dense and traditional AC-taxane chemotherapy.. A total of 112 patients received one of four treatments: non-dose-dense AC-paclitaxel (NDD Pac), dose-dense AC-paclitaxel (DD Pac), non dose-dense AC-docetaxel (NDD Doc), or dose-dense AC-docetaxel (DD Doc).. Transfusion rates were not increased in the dose-dense population; however, rates of grade 2-4 anemia (23% versus 0%, P=0.029), as well as erythropoietin use (58% versus 0%, P <0.0001), were significantly increased in the DD Pac group compared with the NDD Pac group. Grade 3 skin toxicities were significantly increased in the DD Doc group compared with the NDD Doc group (70% versus 11%, P <0.0001).. These results demonstrate that dose-dense AC-taxane therapy may increase rates of anemia and the need for erythropoietin, and decrease rates of neutropenia. The utility of DD Doc appears limited by skin toxicities and its use outside of a clinical study should not be recommended.

Topics: Adult; Aged; Anemia; Antineoplastic Combined Chemotherapy Protocols; Blood Transfusion; Breast Neoplasms; Chemotherapy, Adjuvant; Cyclophosphamide; Docetaxel; Dose-Response Relationship, Drug; Doxorubicin; Erythropoietin; Female; Humans; Incidence; Middle Aged; Neutropenia; Paclitaxel; Retrospective Studies; Skin Diseases; Taxoids

Neonatal lupus erythematosus (NLE) is an inflammatory syndrome in the fetus or neonate associated with the presence of anti-Ro(SSA) and anti-La(SSB) antibodies in the mother. It is characterized by a combination of dermatologic, hematologic, hepatic, and cardiac manifestations. NLE has been reported in twins; we describe neonatal lupus erythematosus occurring in triplets.

Topics: Adrenal Cortex Hormones; Antibodies; Autoantigens; DNA; Erythropoietin; Humans; Immunoglobulins, Intravenous; Infant, Newborn; Lupus Erythematosus, Systemic; Platelet Count; Platelet Transfusion; Ribonucleoproteins; RNA, Small Cytoplasmic; Skin Diseases; Triplets

Topics: Aged; Epoetin Alfa; Erythropoietin; Humans; Injections, Subcutaneous; Male; Mouth Diseases; Polycythemia Vera; Primary Myelofibrosis; Recombinant Proteins; Skin Diseases

Topics: Aged; Deferoxamine; Erythrocytes; Erythropoietin; Humans; Iron; Male; Porphyrias; Porphyrins; Protoporphyrins; Renal Dialysis; Skin Diseases

Topics: Deferoxamine; Erythropoietin; Humans; Kidney Diseases; Male; Middle Aged; Plasma Exchange; Porphyrias; Porphyrins; Recombinant Proteins; Renal Dialysis; Skin Diseases

Haemodialysis-related porphyria cutanea tarda is a rare, but serious and mutilating skin condition, resulting from extremely high plasma porphyrin levels because of their inadequate clearance by haemodialysis. The treatment is very difficult as chloroquine is ineffective and venesection, the conventional treatment of this disease, is not always an option because of anaemia of end-stage renal disease. We report a case of haemodialysis-related porphyria cutanea tarda and her successful management by recombinant human erythropoietin treatment.

Topics: Erythropoietin; Female; Ferritins; Humans; Middle Aged; Porphyrias; Porphyrins; Renal Dialysis; Skin Diseases

Topics: Erythropoietin; Female; Humans; Kidney Failure, Chronic; Long-Term Care; Middle Aged; Porphyrias; Porphyrins; Recombinant Proteins; Renal Dialysis; Skin Diseases

Topics: Blood Volume Determination; Cardiac Catheterization; Diagnosis, Differential; Erythropoietin; Fluoxymesterone; Hemodynamics; Humans; Male; Middle Aged; Polycythemia; Polycythemia Vera; Radionuclide Imaging; Respiratory Function Tests; Skin Diseases; Vascular Diseases