[ @entity5300 and @entity5925 following XXXX abuse. Indications for an immunological cause].

@entity4521 @entity1 @entity2997 @entity1667 @entity12029 @entity4530 @entity167 @entity908 @entity75 @entity5300 @entity5925 @entity1200 @entity158 @entity810 @entity1851
On the morning after taking @entity167 in large amounts together with intranasal @entity4521 , a 25-year-old @entity1 experienced @entity158 , swelling and blistering in both arms together with right brachial plexus paresis. @entity908 kinase (1930 U/l), acute phase proteins and IgE (238 IU/ml) were elevated. The @entity158 was largely relieved by @entity2997 block (given once only), and the swelling and @entity4530 responded to @entity1667 (80 mg daily for 7 days, then gradually reduced). Function returned in the lower division of the brachial plexus within ten days, but the upper division was still paretic 2.5 months later. After injecting @entity4521 intravenously, a 27-year-old @entity1 woke up next morning with fever (39 degrees C) and proximal flaccid paralysis of the right arm. In addition to leucocytosis (25,600/microliters), @entity908 kinase was raised to 28,890 U/l and pANCA to a titre of 1:50 (antineutrophil cytoplasm antibody, perinuclear fluorescence pattern). The cerebrospinal fluid showed increases in cell count (15/microliters) and protein (73 mg/dl). @entity810 supervened after two days but was successfully treated. The paresis was still present at four months, though improved. A 21-year-old @entity1 developed an upper @entity5300 after attempting suicide with intravenous @entity4521 accompanied by @entity12029 (20 mg by mouth) and a bottle of whisky. She had raised levels of @entity1851 (12 mg/dl) and IgM (4.0 milligrams). The paresis cleared up within six weeks without specific therapy. In view of the @entity1200 it seems possible that the immune system was involved in the pathogenesis of the @entity75 and the @entity5925 .
