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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Clinically, the disorder is characterized by an abrupt onset with malaise. Flu-like symptoms are common. Other features include: Palpable purpura: usually distributed over the buttocks and lower limbs (Figure 4.16)Transient non-migratory polyarthritis: a common symptomIntestinal symptoms: including colicky pain, nausea and vomiting, diarrhoea, constipation and the passage of blood and mucus rectallyHaematuria, moderate proteinuria and casts: indicating glomerulonephritis, occurs in 50% of patients
The Viruses
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Flu-like symptoms can be produced by several viruses and by other infectious agents, including bacteria. Influenza imposes a significant disease burden on the population because it occurs in large epidemics every two to four years. The pandemics of 1743, 1889 to 1892, and 1918 to 1919 were widespread and caused particularly serious disease. In the last worldwide influenza pandemic (1918–1919), over 80 million people became ill and there were many deaths. A filterable agent, later named influenza virus, type A, caused the pandemic. Type A influenza viruses are genetically distinct from type B and C influenza viruses and are distinguishable and classified on the basis of serologic differences among their nucleocapsid antigens.
Care of opiate users: detoxification
Published in Berry Beaumont, David Haslam, Care of Drug Users in General Practice, 2021
Withdrawal from opiates can be very unpleasant. The symptoms vary in severity according to factors such as the type of opiate used (methadone is usually more difficult to withdraw from than heroin), the amount used, the length of use, the state of physical frailty of the patient, co-existing painful conditions and the level of motivation. This latter factor is often the most important. Some patients may experience little more than a week or so of severe flu-like symptoms, others will have a miserable period of dysphoria, depression, anxiety, pain, insomnia, vomiting and diarrhoea that can last much longer.
The Results of Interferon-Alpha Treatment in Behçet Uveitis
Published in Ocular Immunology and Inflammation, 2020
Hilal Eser-Ozturk, Yuksel Sullu
Side effects with IFN-α are frequently seen; however, most are dose-dependent and not severe. In the present study, flu-like symptoms were observed in all patients. This is also the most common side effect reported in the literature.3,5,7,10,12 Oral paracetamol was given before the injection and every 6 h if needed following the injection. It was observed that the tolerance developed to this side effect within a week. Another common side effect was weight loss (40%) in the current study. However, this side effect was not as common as our results in the literature.5 One of the most important side effects that cause discontinuation of the treatment is depression. In our study, two patients quit the therapy because of severe depression. Because this side effect occurred within two months, both patients were not included in the statistical analysis. Both of them were taking the maintaining dose when they diagnosed with depression. The remaining patients who quit the treatment because of side effects were on a higher dose of IFN-α. Another concern about IFN-α therapy is the development of anti-IFN-α antibodies and autoantibodies during treatment. However, antibody detection was not included in routine workup in our study.
Comparison of the Treatment Results for Behçet Uveitis in Patients Treated with Infliximab and Interferon
Published in Ocular Immunology and Inflammation, 2020
Nilüfer Yalçindag, Helin Ceren Köse
Interferon α-2a therapy has been associated with many adverse effects such as hair loss, depression, leucopenia, thrombocytopenia, bone marrow fibrosis, myelosuppression, nausea, vomiting, and diarrhea.51–54 Almost all side effects of IFN are dose-dependent, reversible, and occur at treatment initiation. The flu-like syndrome is a common clinical manifestation, especially when starting the treatment. It is the most common phenomenon observed during the first week and may decrease with continuing use.55 The flu-like symptoms are expected in all patients as a sign of nonexisting anti-IFN antibodies.36 Paracetamol should be used 30 min prior to the first injection of IFN and regularly for the first few days to dampen the flu-like symptoms. Flu-like symptoms initially observed in most of our patients and disappeared within a week. In our study, 6% of IFNα-2a patients (2/33) had to discontinue treatment due to severe side effects: depression and urticaria in one patient; major neutropenia and elevated liver enzymes in another patient. In the literature, 4–7.5% of patients had to discontinue their treatment due to side effects.56
Long-Term Efficacy and Safety of Interferon Alpha-2a in the Treatment of Chinese Patients with Behçet’s Uveitis Not Responding to Conventional Therapy
Published in Ocular Immunology and Inflammation, 2019
Peizeng Yang, Guo Huang, Liping Du, Zi Ye, Ke Hu, Chaokui Wang, Jian Qi, Liang Liang, Lili Wu, Qingfeng Cao, Aize Kijlstra
Side effects during the treatment are summarized in Table 3. Most patients experienced flu-like symptoms associated with muscle pain and fever after the first injection. Most of these patients had a spontaneous remission of the flu-like symptoms without any necessary intervention. The flu-like symptoms gradually became mild and frequently disappeared 1 week after the treatment. The second most common side effect was fatigue, which mostly occurred during the first month of treatment. Hair loss was found in 56 patients (44%), which occurred 3 months after treatment and gradually disappeared after 6 months of IFNα-2a treatment. Other side effects including gastrointestinal discomfort, lethargy, arthralgia, depression, insomnia, elevation of serum liver enzymes, skin itch, chest distress and leucopenia was observed in 57%, 46%, 31%, 29%, 25%, 23%, 21%, 15%, and 5% of cases, respectively (Table 3).