posted
Has anyone had a hypersensitivity/allergic reaction or full-blown anaphylaxis from meds? How did it manifest and how did you treat it, as corticosteroids are counterindicated w/ Lyme but I would think would be necessary in some cases.
I reintroduced Rifampin and didn't think it was causing my total inability to breathe these last two weeks, but after reading this abstract I'm not so sure. I didn't realize that scary hypersensitivity reactions/anaphylaxis would happen mainly with the reintroduction of Rifampin:
Medicine (Baltimore). 1999 Nov;78(6):361-9.Click here to read Links Hypersensitivity reactions to rifampin. Pathogenetic mechanisms, clinical manifestations, management strategies, and review of the anaphylactic-like reactions. Mart�nez E, Collazos J, Mayo J.
Section of Infectious Diseases, Hospital de Galdakao, Vizcaya, Spain.
Many of the adverse events induced by rifampin have been considered allergic in origin. The flu-like syndrome and other hypersensitivity reactions seem to be caused by immune complexes, although their pathogenetic mechanisms are not fully elucidated. Many cases have been reported of the flu-like syndrome, thrombocytopenia, hemolytic anemia, and renal failure caused by rifampin. In almost all of the patients in whom they were sought, nonreaginic antirifampin antibodies were detected. On the other hand, anaphylactic reactions seem to be IgE-mediated. We have analyzed the 18 reported cases of anaphylactic reactions severe enough to cause marked hypotension. The interval between the onset of treatment and the anaphylactic reaction was highly variable. Most patients presented with prodromes, mainly rash, before the development of anaphylactic symptoms, and, in most cases, the reaction occurred after reex in most cases, the reaction occurred after reexposure to rifampin. posure to rifampin. Clinical findings include a variety of symptoms, such as fever, exanthem, dyspnea, abdominal pain, and vomiting. Seven of the 9 patients in whom HIV status was known were seropositive, including the only 2 patients who died. We believe that, in case of a non-life-threatening adverse reaction caused by immune complexes, rifampin could be readministered, if necessary, at a more frequent and reduced dose, perhaps with the addition of corticosteroids. In case of anaphylactic reactions the drug should be avoided, although desensitization procedures may be useful. Certain laboratory findings may serve as a clue to predict anaphylactic reactions in patients who have experienced minor adverse events to rifampin. However, the diagnostic value of such findings is not well established and, therefore, patients with previous adverse reactions should be carefully monitored if reexposure to rifampin is essential.
PMID: 10575418 [PubMed - indexed for MEDLINE]
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Posts: 929 | From Massachusetts | Registered: Oct 2007
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bettyg
Unregistered
posted
hi mcs, scrolling on by since i can't read the block, long text above.
you might get more readers than scrollers if you would break up that really long paragraph into MANY SHORT ones.
just going to copy/paste my welcome letter vs. taking the time to just copy it since i'm still sending out welcome notes to folks! thanks for understanding...it's a timesaver to me
Welcome; i'm so glad you found us!! You've come to the right place for education and support!
Dr. Burrascano's most recent "Diagnostic Hints and 2008 Treatment Guidelines for Lyme and Other Tick Borne Illnesses" @
please go to my newbie links, copy the entire thing, and then print this off....FINANCIAL BURDENS compiled by melanie reber print off pages 74 - 92; outstanding info there. i believe there are a few more general comments there without links!! print that off too as it's newer info from members thru their own personal, tragic experiences.
Betty's suggested POSTING GUIDELINES . many of us have neuro lyme where we can NOT read long solid block text and be able to comprehend and read it as is.
please edit your post by CLICKING PAPER/PENCIL ICON to right of your name. that opens up BOTH subject line and body text.
now please break up your WORDY SENTENCES into one sentence paragraphs. Then hit ENTER KEY ``TWICE`` after each paragraph; we need that space for comprehension.
NOTE: you do NOT have to use " ", just show the name of person you are responding to, and then type your comment.
IF you need to use "", PLEASE DELETE "bold" codes so it's regular type text we read vs. the dark, harsh/painful bolding, delete the first 4 characters of 2ND LINE of a ""
[QB] just delete these 4 characters, and bolding is GONE! my eyes will really appreciate that; it's one very bad side effect of my having lyme for 38.5 years!! xox
then go to left hand corner and mark box to receive ALL REPLIES, and click EDIT SEND
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posted
Was wondering how you were doing. Doesn't sound like things are getting any better.
The only med hubby had an allergic reaction to was Mepron. He broke out in itchy hives. Within 24 hours he had an allover body rash. His skin turned beet red and he gained 10 pounds of fluid weight.
This was 10 days after starting the med. He stopped the med and had to take fluid pills for a while. Was painful as the skin on his fingers and ears peeled off from the swelling. I think it took a couple of weeks for the rash and redness to go away.
If Rifampin is the only med you have changed since you started having the severe breathing problems then I would probably stop it and see what happens.
Hubby has been on 30 mg of hydrocortisone daily since early October. Most alternative docs consider this the maximum therapeutic dose of Cortef for adrenal support. We recently decreased it to 25 mg.
When hubby was a patient of the Dr B he was taking 5 mg daily of Cortef. Was on that dose for several years and then stopped for a couple of years, but went on the higher dose when he crashed last October. If you are taking antibiotics while on low dose hydrocortisone most LLMD's don't have a problem with prescribing the Cortef at low doses.
Wish I could help more.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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lpkayak
Honored Contributor (10K+ posts)
Member # 5230
posted
bactrim=immediate hives for ne
at a meeting once i saw awoman covered with hives from plaquinel
-------------------- Lyme? Its complicated. Educate yourself. Posts: 13712 | From new england | Registered: Feb 2004
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posted
How does anaphylaxis occur? I had to look it up, all defintions say it it is an allergic reaction to a drug or other substance resulting from prior exposure.
So anaphylaxis would occur when we restart a medication we had previously taken and tolerated? That is scary to even think about!
From a medical/scientific perspective, how or why does anaphylaxis occur, if the drug was previously taken with no problems?
I also noted in the Rifampin report that: "Seven of the 9 patients in whom HIV status was known were seropositive, including the only 2 patients who died." So it seems that this reaction may be more likely to occur in immunocompromised patients? I suppose that could also occur in chronic Lyme, since we often have weaker immune system than healthy people. Again, very scary thought!
I'd be interested to hear if anyone else has had this type of reaction only after restarting a drug previously tolerated.
Posts: 29 | From USA | Registered: Feb 2009
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posted
LymeCFIDSMCS: Your reaction sounds personally very scary, and I'm so sorry you are going through this.
Have you called your LLMD about your breathing problems since restarting Rifampin?
Unless breathing difficulties are a common side effect or herx reaction on Rifampin (as with Mepron and other babesia meds), I suggest you stop the Rifampin until you can discuss with your LLMD.
I hope you get more answers and feel better soon.
Posts: 29 | From USA | Registered: Feb 2009
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posted
I did stop the Rifampin yesterday and left a message for my LLMD, who thinks I need emergency care -- but, it's complicated, I just can't get it due to the severity of my chemical sensitivities. Because I went to a hospital in December, I have been completely bedbound and trapped in a room devastatingly ill for three months. So either way it's dangerous.
It had not occurred to me that Cortef would be a good idea but that's a good idea. I took it once in the past and was not able to tolerate it that well, but maybe at an even more teeny dose (I think it gave me insomnia/wired feeling).
Sorry about not breaking up the text of that abstract -- I just forgot!!! Here is it again:
Medicine (Baltimore). 1999 Nov;78(6):361-9.Click here to read Links Hypersensitivity reactions to rifampin. Pathogenetic mechanisms, clinical manifestations, management strategies, and review of the anaphylactic-like reactions. Mart�nez E, Collazos J, Mayo J.
Section of Infectious Diseases, Hospital de Galdakao, Vizcaya, Spain.
Many of the adverse events induced by rifampin have been considered allergic in origin. The flu-like syndrome and other hypersensitivity reactions seem to be caused by immune complexes, although their pathogenetic mechanisms are not fully elucidated.
Many cases have been reported of the flu-like syndrome, thrombocytopenia, hemolytic anemia, and renal failure caused by rifampin. In almost all of the patients in whom they were sought, nonreaginic antirifampin antibodies were detected.
On the other hand, anaphylactic reactions seem to be IgE-mediated. We have analyzed the 18 reported cases of anaphylactic reactions severe enough to cause marked hypotension. The interval between the onset of treatment and the anaphylactic reaction was highly variable.
Most patients presented with prodromes, mainly rash, before the development of anaphylactic symptoms, and, iin most cases, the reaction occurred after reexposure to rifampin.
Clinical findings include a variety of symptoms, such as fever, exanthem, dyspnea, abdominal pain, and vomiting. Seven of the 9 patients in whom HIV status was known were seropositive, including the only 2 patients who died.
We believe that, in case of a non-life-threatening adverse reaction caused by immune complexes, rifampin could be readministered, if necessary, at a more frequent and reduced dose, perhaps with the addition of corticosteroids.
In case of anaphylactic reactions the drug should be avoided, although desensitization procedures may be useful. Certain laboratory findings may serve as a clue to predict anaphylactic reactions in patients who have experienced minor adverse events to rifampin.
However, the diagnostic value of such findings is not well established and, therefore, patients with previous adverse reactions should be carefully monitored if reexposure to rifampin is essential.
PMID: 10575418 [PubMed - indexed for MEDLINE]
Related Articles
Posts: 929 | From Massachusetts | Registered: Oct 2007
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sutherngrl
Frequent Contributor (1K+ posts)
Member # 16270
posted
Could be yeast in the throat. I started Minocycline and had to stop temporarily and started back. I had taken large doses of zith in between. My throat felt like it was closing up when I re-started the Mino.
Went to LLMD. He cultured my throat and it was yeast and a bacteria called Fusobacterium. So even though it felt like it could have been a reaction to the med, it wasn't.
Very scary though to feel like your throat is closing up. Mine has been like that for 3 weeks now.
I would definetly have your LLMD check your throat out for other culprits such as yeast. I did not even know that yeast could make your throat feels this way; plus I guess having a throat infection on top of it. You just never know.
I would discontinue the med until you see your doc.
Posts: 4035 | From Mississippi | Registered: Jul 2008
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posted
I think the most common adverse drug reaction in general is hives or rash. Sometimes it itches (pruritus), sometimes not.
Anaphylaxis is a fairly specific reaction - the antigen (the drug in this case) is recognized by Immunoglobulin E (IgE) as a foreign substance and bound. IgE in turn binds to mast cells which release histamine, histamine causes blood vessels to expand (vasodilation). Fluid leaks from the blood into tissues (especially the mucosal lining of the throat and mouth) and when they swell breathing is restricted. The vasodilation also causes BP to drop also (hypotension).
Allergic reactions (not necessarily anaphylaxis) with re-exposure is not uncommon, the first exposure produces antibodies to the substance, then the second exposure causes problems when those antibodies activate different parts of the immune system.
Bea, that sounds like a pretty severe reaction your husband had - the peeling skin sounds a bit like Stevens Johnson syndrome - sorry to hear that he went through that.
Posts: 263 | From Capital Region, NY, USA | Registered: Jun 2008
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posted
Sutherngrl, what are you doing now to treat the yeast and particularly the fusobacterium? I think I did read that you were taking Flagyl? Does anything else treat it? I can't take Flagyl as it gave me peripheral neuropathy, and I do have Nystatin to take but hadn't been taking it so I will go back on it. Thank you.
Yes, I haven't had hypotension and generally my blood pressure IS really low, but it has actually been more stable than usual, so that made me think it wasn't anaphylaxis.
Posts: 929 | From Massachusetts | Registered: Oct 2007
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