Syndrome of intolerance to multiple medicines
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Abstract
Multiple drug intolerance syndrome (MDIS) is characterized by intolerance to two or more unrelated drugs. It has a low prevalence, being common in patients with polypharmacy. Although adverse reactions to medications are very common, it is rare for patients to debut with this syndrome, which has mild to severe clinical implications that affect the life of the patient, depending on this, the approach and its management.
The symptoms presented vary from gastrointestinal symptoms such as gastroesophageal reflux, muscle aches and headaches, to skin symptoms, these being the most frequent, such as urticaria and maculopapular eruptions or the less common presentations of Steven-Johnson syndrome.
MDIS is caused by a wide variety of drugs, therefore knowledge of the syndrome, as well as an adequate questioning of the patient’s history, is necessary to make a timely diagnosis and thus establish an adequate and preventive, management avoiding adverse reactions that put the patient’s life at risk. With the findings of the clinical picture in the patient, based on the previous allergic history to different unrelated drugs, plus the presentation of a generalized maculopapular rash after the administration of trimethoprim / sulfamethoxazole, the diagnosis of MDIS is made. It was decided to change the drug for fosfomycin, with a consequent favorable evolution.
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