Autoři předkládají popis případu 90leté ženy léčené dva roky pro psoriázu acitretinem, u níž byl pozorován spontánní vznik hemorhagických puchýřů na končetinách, na sliznicích dutiny ústní a rozsáhlých podkožních sufuzí a hematomů. Diferenciálně-diagnosticky bylo pomýšleno na závažné alergické projevy po cotrimoxazolu, na plazmocelulární neoplazii, amyloidózu či bakteriální endokarditidu. Mikroskopické a kultivační vyšetření sanguinolentního punktátu bylo uzavřeno jako suspektní kontaminace. Imunoelektroforéza séra neprokázala paraprotein. Při doplnění anamnézy byla zjištěna měsíce trvající xeroftalmie, xerostomie, křehkost nehtů a vypadávání vlasů, což jsou projevy konzistentní s hypervitaminózou A. Krvácivé projevy ustaly během několika dnů od vysazení acitretinu. Sérová koncentrace léčiva ani retinolu stanoveny nebyly.
The authors present a clinical case of a 90 years old woman treated with acitretin for psoriasis during past two years, in whom develloped spontaneously haemorrhagic blisters on extremities, on oral mucosal surfaces and large subcutaneous hematomas. In the differential diagnostic work-up an allergy to co-trimoxazole, plazmocellular neoplasia, amyloidosis and bacterial endocarditis were suspected. Both microscopic evaluation as microbial cultivation of the aspirated hemorrhagic fluid were concluded as contamination. There were no signs of paraproteinemia in serum immunoelektrophoresis study. Extended medical history revealed till months persisting xerophthlamia, xerostomia, nail fragility and hair loss, which all are consistent with hypervitaminosis A. The bleeding signs subsided within several days after acitretin withdrawal. Both the drug serum concentrations and retinol concentrations were not performed.
- MeSH
- Acitretin * administration & dosage metabolism adverse effects MeSH
- Diagnosis, Differential MeSH
- Hypervitaminosis A * chemically induced diagnosis pathology MeSH
- Clinical Studies as Topic MeSH
- Contraindications MeSH
- Hemorrhage etiology MeSH
- Drug Interactions MeSH
- Humans MeSH
- Withholding Treatment MeSH
- Nutritive Value MeSH
- Psoriasis drug therapy MeSH
- Aged, 80 and over MeSH
- Check Tag
- Humans MeSH
- Aged, 80 and over MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
The aim of this study was to assess the antioxidant status of rat liver in various periods of postnatal development after affecting the pregnancy by high doses of vitamin A. Wistar rats of both sexes were used. Vitamin A (10 mg per kg of body weight) was administered to rats in gestation on days 8 through 10 per os. Biological activities of antioxidant enzymes were measured spectrophotometrically in experimental groups and controls. Superoxide dismutase showed a significant activity increase on postnatal day 7 in the experimental group. The glutathione peroxidase activity was highest on postnatal day 7 and showed a significant increase on day 14 in the experimental group. Glutathione reductase activity significantly increased only on days 1 and 21 and decreased on day 7. The glutathione content remained relatively constant in both groups although a slight depletion on day 7, in parallel to enzyme activities, suggested a higher level of oxidative stress. Our results demonstrate that hypervitaminosis A in pregnancy does not influence the postnatal antioxidant status.
- MeSH
- Financing, Organized MeSH
- Glutathione Peroxidase analysis adverse effects MeSH
- Glutathione Reductase analysis adverse effects MeSH
- Hypervitaminosis A embryology metabolism MeSH
- Mitochondria, Liver enzymology MeSH
- Liver enzymology metabolism MeSH
- Models, Animal MeSH
- Animals, Newborn MeSH
- Rats, Wistar MeSH
- Spectrophotometry methods MeSH
- Superoxide Dismutase analysis adverse effects MeSH
- Pregnancy MeSH
- Vitamin A administration & dosage metabolism adverse effects MeSH
- Free Radicals metabolism MeSH
- Animals MeSH
- Check Tag
- Pregnancy MeSH
- Animals MeSH
- MeSH
- Nutritional Physiological Phenomena MeSH
- Hypervitaminosis A MeSH
- Ascorbic Acid administration & dosage biosynthesis physiology chemistry MeSH
- Humans MeSH
- Vitamin A Deficiency physiopathology MeSH
- Ascorbic Acid Deficiency MeSH
- Vitamin E Deficiency MeSH
- Vitamin A administration & dosage biosynthesis physiology chemistry MeSH
- Vitamin E administration & dosage biosynthesis physiology chemistry MeSH
- Vitamins * biosynthesis classification metabolism MeSH
- Check Tag
- Humans MeSH
- MeSH
- Adult MeSH
- Hypervitaminosis A psychology MeSH
- Carotenoids MeSH
- Humans MeSH
- Vegetables MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
