Idiosyncratic reaction symptoms and conditions

P03.16
Idiosyncratic Reaction to Mirena IUS A Cause for Early Removal - Case Report
Sivarajan, S; Aung, SN; Haloob, R
Basildon University Hospital, UK
Background: The discontinuation rate for mirena IUS was around 40%. The common
causes for premature removal were excessive bleeding, spotting, infection and pain.
We all are aware of less systemic effects compared to other progestational agents, We
would like to highlight the importance of exaggerated minerolocorticoid activity in the
form of increased fluid retention and electrolyte changes with spontaneous changes in
weight and generalized edema following mirena IUS which result in early removal.
In our two cases, we highlight the exacerbation of well documented side effects of
progesterone which leads to premature removal of MIRENA IUS.
In my first case,Twenty four hours after insertion of mirena IUS she noticed ankle
swelling, 48 hours later swelling involved the whole lower limb and worse over the
following few days.In addition to heavy vaginal bleeding.At the end of the first week,
she put on weight three quarters of a stone (10.5 lb).Mirena was removed at surgery
after 8 days of insertion and she developed continuous diuresis and profuse sweating
within 24hrs of removal her weight went down by 7lbs.
In the second case ,following mirena IUS insertion Three months later her periods
improved a lot , but she suffered considerable weight gain(7lb) and mood swings. So
she decided to have her mirena removed and opted for Novasure ablation.
Conclusion: Although abdominal pain,peripheral oedema,nervousness are well
documented side effects of Mirena,we couldn’t find in literature of fulminant oedema
and water retention after 24 hours of Mirena insertion. This profound acute side effects
might be due to acute idiosyncratic immune reaction of to progesterone

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Thank you, Mo, for finding this info on the net!

Claudia

My significant other took Doxycylene, 100 mg, twice a day for two weeks to treat a swollen lymph node under his arm. During the treatment he experienced nausea, stomach pain, rash and cold sweats, nothing too bad. 3 days after the last dose everything got significantly worse. It started with sever chest pain, so bad we went to the emergency room thinking it was a heart attack or blood clot. They found nothing and discharged him. Over the next 3 weeks he started vomitting, diahrea and developed jaundice. Constant queeziness and chest pain. After numerous tests, ultra sounds, MRCP, the doctor has ruled out various hepatitas's and every other disease he could think of. He's also rulled out any kind of bile duct blockage after the MRCP. Its now been 7 weeks since all this started, my friend has dropped 40 lb's (190 down to 152) and still dropping. Our doctor (gastro interologist) has admitted he's stumped and is currently contacting a professor in Miami as a last hope. The only thing our doctor keeps comming back to is the Doxycyclene and that my friend may have had that one rare acute reaction. We're frazzled and don't know what to do next.