Swiss medical weekly
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We evaluated the records of 139 pediatric patients with Schönlein-Henoch purpura (aged 0.4 to 15.1 years, median 5.4 years), referred from 1974 to 1993 to the University Children's Hospital, Berne. An acute febrile illness preceded Henoch-Schönlein purpura in 83 (60%) out of the 139 children. The purpuric papules were distributed over the lower extremities and the buttocks in 68 patients (49%), and more extensively in the remaining 71 (51%). ⋯ Its outcome is almost always favourable. Children with heavy proteinuria tend in some cases to develop renal failure. For these patients, new treatment regimens aimed at preventing renal failure warrant evaluation in prospective controlled studies.
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Swiss medical weekly · Feb 1996
Case Reports[Exacerbation of pseudoparalytic myasthenia gravis following azithromycin (Zithromax)].
We report the case of a 25-year-old female patient with severe aggravation of myasthenia gravis due to azithromycin which was prescribed for an influenza syndrome. One hour after the intake of 500 mg azithromycin the patient developed weakness of the legs and respiratory distress due to respiratory muscle failure. She was hospitalized in a comatose state and required intubation and mechanical ventilation for six days. ⋯ Erythromycin causing aggravation of myasthenia gravis by interfering with neuromuscular transmission is reported in the literature. The close temporal relationship between the intake of azithromycin and severe worsening of myasthenia gravis in our patient suggests that azithromycin, a new azalid-antibiotic of the macrolid group, can exacerbate myasthenia gravis. We conclude that azithromycin should be added to the list of drugs to be used with caution in patients with myasthenia gravis.