[ XXXX : paradoxical @entity137 ; a discussion of 4 cases].

@entity1 @entity410 @entity137 @entity909 @entity3174 @entity302 @entity1445
INTRODUCTION: @entity3174 @entity1445 results in a wide variety of signs and symptoms - ataxia, nistagmus, @entity909 . On occasions increased frequence of @entity410 may be seen in @entity1 with high @entity3174 serum levels and no evidence of standard @entity137 symptoms - paradoxical @entity137 . OBJECTIVE: To study the frequency of @entity3174 paradoxical @entity137 , and to analyze @entity1 " clinical status. @entity1 AND METHOD: Prospective study of 100% of @entity1 monitored by the Pharmacy Department during August-December, 1998 and who had @entity3174 serum levels above therapeutic range and @entity410 . Laboratory determinations in samples was performed by polarized immunofluorescence analysis. The outcome of each @entity1 was monitored through their pharmacotherapeutic record and clinical history. RESULTS: The number of @entity1 was 1706; 124 of wich had serum levels above the therapeutic range. Out of this group, 3 males and 1 female, with ages ranging from 17 to 73, a diagnosis of @entity302 , and chronic therapy using @entity3174 , come to our Emergency Department because of @entity410 . Serum levels of @entity3174 were ordered due to suspected lack of compliance or underdosing. In all 4 @entity1 @entity3174 was discontinued until the therapeutic range was reached, to be then reset with plasma level-adjusted dosages. CONCLUSIONS: Paradoxical @entity137 may lead to errors, and therefore we should rule out such possibility in @entity1 with exacerbated @entity302 undergoing treatment with @entity3174 .
