Zidovudine


Dideoxynucleoside analog of thymidine, acting as a virostatic drug against HIV by interfering with viral reverse transcriptase.
 
Incidence
Few cases of zidovudine allergy have been published.
 
Risk factors
Unknown.

Clinical manifestations
Erythroderma

Maculopapular rash

Urticaria

Fever

Leukocytoclastic vasculitis

Bronchospasm

Diagnostic methods
No in vitro or in vivo tests are available.
 
Mechanisms
Unknown.
 
Possible production of toxic metabolites (like sulfonamides).
 
Management
Desensitization.
 
2 protocols have been published.
  • 0.008 mg to 1 200 mg (37 days)
  • 10 mg to 500 mg (10 days)
The protective effect of corticosteroids is controversial.

References

  1. Duque D, de la Puente J, Rodriguez F, Pellon L.F, Maquiera E, Jerez J, "Zidovudine-related erythroderma and successful desensitization: a case report", J. Allergy. Clin. Immunol., 1996 ; 98: 234-5
  2. Carr A, Penny R, Cooper D.A, "Allergy and desensitization to zidovudine in patients with acquired immunodeficiency syndrome (AIDS)", J. Allergy. Clin. Immunol., 1993 ; 91 (2): 683-85
  3. Mc Kinley G.F, Mazza D.S, Grieco M.H, "Urticarial reaction to zidovudine", Lancet., 1990 ; 336: 384

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.