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Biomedical subjects

Dominique Tennstedt

Publications and source records attributed to Dominique Tennstedt.

4 recordsLinked to original sources
PubMed2006

Solitary pancreas transplantation for life-threatening allergy to human insulin.

We report on a 30-year-old man, with type 1 diabetes mellitus, who developed generalized allergy to insulin consisting of several bouts of tremor, tachycardia, breathlessness and syncope. Strong positive reactions to protamine and metacresol were demonstrated by skin-prick testing. Symptoms persisted despite the use of antihistamine therapy, Actrapid HM Paraben and Monotard (insulin without protamine and metacresol) and immunosuppression (tacrolimus). He underwent a cadaver pancreas transplantation with portal-enteric drainage in June 2003. Following the antithymocyte globulin induction, immunosuppression consisted in tacrolimus and sirolimus without steroids. The patient subsequently reported a complete resolution of his symptoms and excellent glycaemic control. Thirteen months after transplantation, the patient developed oral ulcerations and severe leucopoenia initially attributed to sirolimus, which was subsequently stopped. A hyperglycaemic episode following corticosteroid therapy for acute rejection therapy required the reintroduction of insulin. Allergic manifestations reappeared promptly. Currently, 2 years after transplantation, the patient is euglycaemic without insulin (glycated haemoglobin 5.8%) and he is free of allergic reactions.

Adult↗
PubMed2004

Drug-induced eosinophilia and multisystemic failure with positive patch-test reaction to spironolactone: DRESS syndrome.

We report the case of a 58-year-old man who suffered from a generalized and intolerable itching one month after starting treatment with colchicine, amiodarone, perindopril, allopurinol and spironolactone. From the start of treatment he had progressively developed erythroderma, fever, anorexia and prostration, oedema of both hands and face, hypereosinophilia (42%; 5810 eosinophils/mm3), hepatic failure (including cholestatic jaundice, cytolysis, coagulation abnormalities and hypoproteinaemia), exocrine pancreatic failure (with severe steatorrhoea), renal failure, metabolic acidosis, aggravation of pre-existing cardiac insufficiency and oedema of the lower extremities. All medications were stopped and the condition improved slowly until complete remission was reached 4 months later. Patch-testing was performed, including the various drugs. All the tests (including components of the vehicles) were negative, except for spironolactone, which gave a strong positive reaction. Ten controls in healthy volunteers were negative. The diagnosis of drug rash with eosinophilia and systemic symptoms (DRESS) induced by spironolactone was made. This is the first report of DRESS due to spironolactone.

Drug Eruptions↗
PubMed2002

[Occupational dermatitis: irritation or allergy?].

Occupational dermatitis is a very frequent subject of consultation, as much in general practice as in dermatology. The most frequently found pathologies are linked to environmental factors. In these cases, irritant dermatitis and allergic contact dermatitis represent the majority of the cutaneous problems. Rigorous history taking associated with an attentive examination and a few investigations, essentially consisting of skin testing, form an incontestable tripod. The therapeutic approach, as much preventative as curative, can only be envisaged after having made a precise diagnosis, of which the conclusions should be pertinent and adapted to each patient presenting in consultation. In occupational disease, the distinction between irritant dermatitis and allergic contact dermatitis is primordial.

Dermatitis, Allergic Contact↗