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Mesna side effects which imitate vasculitis

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Summary

Mesna (sodium-2-mercaptoethansulfonate) is used in the prophylaxis of cyclophosphamide (CYC)-induced hemorrhagic cystitis. Four patients being treated with “low dose” CYC and prednisone for vasculitis developed severe side effects to Mesna. Fever, arthralgia, myalgia, tachycardia, electrocardiogram changes consistent with perimyocarditis, erythroderma, bullous skin and mucous membrane lesions, and abdominal complaints with profuse diarrhea were noted approximately 3 weeks after the initiation of therapy for CYC-induced leukopenia and a conservatively reduced prednisone dosage. Positive reexposure tests confirmed the association to Mesna use, and hypersensitivity skin tests demonstrated a delayed hypersensitivity reaction.

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Abbreviations

CYC:

cyclophosphamide

WBC:

white blood count

ANA:

antinuclear antibodies

AP:

alkaline phosphatase

SGPT:

serum glutamic pyruvic transaminase

SGOT:

serum glutamic oxaloacetic transaminase

SGGT:

serum γ-glutamyl transaminase

ECG:

electrocardiography

ANCA:

antineutrophil cytoplasmic antibodies

cANCA:

cytoplasmic fluorescence pattern

pANCA:

perinuclear fluorescence pattern

PR3:

proteinase-3-antibodies

WG:

Wegener's granulomatosis

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Author information

Author notes

  1. E. Reinhold-Keller

    Present address: Rheumaklinik Bad Bramstedt, Oskar-Alexander-Strasse 26, W-2357, Bad Bramstedt, Germany

Authors and Affiliations

  1. Abteilung klinische Rheumatologie der Medizinischen Universität zu Lübeck und Medizinische Krankenhausabteilung der Rheumaklinik Bad Bramstedt, Bad Bramstedt, Germany

    E. Reinhold-Keller, J. Mohr & W. L. Gross

  2. Hautklinik der Christian-Albrechts-Universität Kiel, Bad Bramstedt, Germany

    E. Christophers

  3. Mühlenberg-Klinik, Malente

    K. Nordmann

Authors
  1. E. Reinhold-Keller
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  2. J. Mohr
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  3. E. Christophers
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  4. K. Nordmann
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  5. W. L. Gross
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Reinhold-Keller, E., Mohr, J., Christophers, E. et al. Mesna side effects which imitate vasculitis. Clin Investig 70, 698–704 (1992). https://doi.org/10.1007/BF00180290

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  • DOI: https://doi.org/10.1007/BF00180290

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