Allergic eosinophilia

Acute drug-related hypersensitivity reactions (allergic responses) may cause tubulointerstitial nephritis, which will damage the tubules and interstitium. These reactions are most commonly observed with administration of methicillin and other synthetic antibiotics as well as furosemide and the thiazide diuretics. The onset of symptoms occurs in about 15 days. Symptoms include fever, eosinophilia, hematuria (blood in the urine), and proteinuria (proteins in the urine). Signs and symptoms of acute renal failure develop in about 50% of the cases. Discontinued use of the drug usually results in complete recovery however, some patients, especially the elderly, may experience permanent renal damage. 

Devos, R., Plaetinck, G., Cornelis, S., Guisez, Y., Van der Heyden, J., and Tavernier, J. 1995. Interleukin-5 and its receptor a drug target for eosinophilia associated with chronic allergic disease. Journal of Leukocyte Biology 57, 813-818. 

Walker C, Virchow J-C, Bruijnzeel PLB, Blaser K T cell subsets and their soluble products regulate eosinophilia in allergic and nonallergic asthma. J Immunol 1991 146 1829-1835. 

Adverse reactions may include drowsiness ataxia dizziness slurred speech headache vertigo weakness impairment of visual accommodation euphoria overstimulation paradoxical excitement nausea vomiting diarrhea palpitations tachycardia various arrhythmias syncope hypotensive crises allergic/idiosyncratic reactions leukopenia acute nonthrombocytopenic purpura petechiae ecchymoses eosinophilia peripheral edema fever hyperpyrexia chills angioneurotic edema bronchospasm oliguria anuria anaphylaxis erythema multiforme exfoliative dermatitis stomatitis proctitis Stevens-Johnson syndrome bullous dermatitis paresthesias agranulocytosis aplastic anemia thrombocytopenic purpura. 

Devos, R. et al. (1995). Interleukin-5 and its receptor a drug target for eosinophilia associated with chronic allergic... 

Mild allergic reactions including rash and eosinophilia occur rarely... 

The common side effects are nausea and vomiting. The others are allergic symptoms including drug fever, skin rash, urticaria, eosinophilia, photosensitization reactions, serum sickness like syndrome. Stevens-Johnson syndrome and exfoliative dermatitis are also common with longer acting agents. 

All loop diuretics, with the exception of ethacrynic acid, are sulfonamides. Therefore, skin rash, eosinophilia, and less often, interstitial nephritis are occasional adverse effects of these drugs. This toxicity usually resolves rapidly after drug withdrawal. Allergic reactions are much less common with ethacrynic acid. 

Other allergic reactions include fever, eosinophilia, and rashes. 

Allergic-like reactions (iodine fever, eosinophilia, serum People with hypocomplementemic vasculitis... 

Erythromycins, particularly the estolate, can produce acute cholestatic hepatitis (fever, jaundice, impaired liver function), probably as a hypersensitivity reaction. Most patients recover from this, but hepatitis recurs if the drug is readministered. Other allergic reactions include fever, eosinophilia, and rashes. 

In food allergy, serum IL-5 was found to be elevated in infants with anaphylaxis to cow s milk at 1 week, but became undetectable after 2 weeks on a milk-free diet (M9). It seems likely that the allergic inflammation due to cow s milk or other food allergens can induce marked eosinophilia with an associated increase in IL-5 production. Therefore, IL-5 may serve as a marker for food allergy. Other studies have also shown that IL-5 expression correlates significantly with eosinophilia and allergic symptoms of allergic rhinitis in patients with hay fever (W13). 

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