misoprostol and Syndrome

We sought to compare the efficacy and safety of oral misoprostol administered to patients with the efficacy and safety in a control group treated with a Foley catheter and oxytocin for induction of labor.. Two hundred patients requiring induction of labor at term with a Bishop score of

Topics: Administration, Oral; Adult; Catheterization; Cervical Ripening; Female; Gestational Age; Humans; Infant, Newborn; Labor, Induced; Misoprostol; Obstetric Labor Complications; Oxytocics; Oxytocin; Parity; Pregnancy; Syndrome; Time Factors; Uterine Contraction

Topics: Abortion, Induced; Female; Fetus; Humans; Methotrexate; Misoprostol; Pregnancy; Syndrome

Idiosyncratic drug reactions appear to be immune-mediated. Immune responses are driven by helper T cells (Th); Th1 responses promote cell-mediated immunity, whereas Th2 responses drive antibody-mediated reactions. Th1 cytokines inhibit Th2 responses and Th2 cytokines inhibit Th1 responses; therefore, it may be possible to prevent idiosyncratic drug reactions by changing the Th1/Th2 cytokine balance. We tested this hypothesis in an animal model in which penicillamine causes an autoimmune syndrome in Brown Norway rats. This syndrome has the hallmarks of a Th2-mediated response and we tried to inhibit it with a polymer of inosine and cytosine (poly I:C), a Th1 cytokine-inducer. However, we found that a single dose of poly I:C, given at the onset of penicillamine treatment, significantly increased both the incidence (100 vs. 60%) and accelerated the onset (30+/-4 vs. 39+/-5 days) of penicillamine-induced autoimmunity when compared with controls. To rule out other effects of poly I:C that might overshadow the induction of Th1 cytokines, we directly tested the effects of the prototypic Th1 cytokine, interferon-gamma. Although not as dramatic, interferon-gamma-pretreatment also appeared to make the syndrome worse. Conversely, when we used misoprostol, a prostaglandin-E analog that inhibits Th1 cytokines, it completely protected the animals. Just one dose of misoprostol prior to initiation of penicillamine treatment was sufficient to provide this protection. The syndrome was also completely inhibited by aminoguanidine, an inhibitor of iNOS. These results, although dramatic, suggest that the effects of these agents were not mediated by their effects on Th1/Th2 balance, but rather by some other mechanism.

Topics: Animals; Autoimmune Diseases; Autoimmunity; Drug Eruptions; Immunoglobulin E; Interferon Inducers; Interferon-gamma; Interleukin-4; Misoprostol; Models, Animal; Nitrites; Penicillamine; Poly I-C; Rats; Rats, Inbred BN; Rats, Inbred Lew; Syndrome; Th1 Cells; Th2 Cells

We report a case showing the association of Moebius syndrome, the use of misoprostol during pregnancy and the development of central congenital alveolar hypoventilation. Pathophysiological aspects of these three diseases are discussed and also the unfavorable prognosis of this association.

Topics: Abnormalities, Multiple; Abortifacient Agents, Nonsteroidal; Humans; Infant; Male; Misoprostol; Respiration, Artificial; Sleep Apnea Syndromes; Syndrome

Topics: Abnormalities, Multiple; Chorionic Villi Sampling; Female; Fetus; Humans; Infant, Newborn; Misoprostol; Pregnancy; Syndrome

Topics: Abnormalities, Drug-Induced; Animals; Cranial Nerves; Female; Humans; Limb Deformities, Congenital; Misoprostol; Paralysis; Rats; Syndrome; Uterine Contraction

Misoprostol, a synthetic analog of prostaglandin, has been widely used in Brazil as an abortifacient. Abortion is illegal in Brazil. An uncertain number of these abortion attempts are unsuccessful and the pregnancy continues. We report on 7 patients whose mothers attempted to abort using this drug in the first trimester of gestation without success. The 7 patients presented with limb defects and in 4 of them a diagnosis of Möbius sequence was made.

Topics: Abnormalities, Drug-Induced; Abnormalities, Multiple; Abortion, Criminal; Brazil; Cranial Nerve Diseases; Ectromelia; Facial Paralysis; Female; Foot Deformities, Congenital; Hand Deformities, Congenital; Humans; Infant, Newborn; Male; Misoprostol; Pregnancy; Syndrome