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A retrospective analysis study involving 80 patients from March 2013 to June 2023 reported a case of lack of efficacy of bevacizumab in preventing cerebral radiation necrosis in a patient with non-small cell lung cancer and brain metastases. Despite receiving bevacizumab along with stereotactic radiotherapy, the patient still experienced SRT-induced cerebral radiation necrosis, indicating a lack of effectiveness in this case. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventIn a retrospective study 26 patients conduceted between 1 January 2015 to 31 January 2024, et al. patient [age and sex not stated] was described, who developed grade 4 hypertension secondary to bevacizumab 10 mg/kg biweekly while being treated for radiation induced brain necrosis [RBN; route, duration of treatment to reaction onset and outcome not stated]. Hence, bevacizumab was discontinued. [Extracted from the article]

This article from Reactions Weekly reports on three cases of injection site necrosis following administration of the pneumococcal vaccine. The study examined 48 patients who experienced adverse events after receiving the vaccine, but specific details such as age, sex, route of administration, dosage, time to reaction onset, and outcome were not provided. In each case, the patients developed necrosis in different tissues, including fat, fascia, and muscle. Further research is needed to understand the potential risks associated with the pneumococcal vaccine. [Extracted from the article]

A 15-year-old girl was admitted to the emergency department after ingesting a large amount of paracetamol in a suicide attempt. She experienced vomiting and abdominal pain, and her blood paracetamol level was found to be low. Her creatinine levels peaked on day 5 after ingestion but gradually returned to normal by day 9. Urine analysis indicated acute kidney injury with acute tubular necrosis. The girl received fluid therapy and psychological treatment during her hospitalization and was discharged after 7 days, having recovered well. [Extracted from the article]

A 28-year-old woman experienced drug toxicity and lack of efficacy during immunosuppressive therapy with tacrolimus, mycophenolate mofetil, and prednisolone after receiving a renal transplant. She developed diffuse cortical necrosis of the renal allograft, resulting in renal allograft failure. The woman underwent nephrectomy and is currently undergoing biweekly hemodialysis. The drug toxicity was attributed to tacrolimus, mycophenolate mofetil, and prednisolone. [Extracted from the article]

A retrospective case series involving 13 patients with brain lesions who received stereotactic radiosurgery or stereotactic radiation therapy was described. Some of these patients developed focal radiation necrosis of the brain (fRNB) while being treated with immunotherapy drugs for melanoma, cerebellar medulloblastoma, non-small cell lung carcinoma (NSCLC), or renal cell carcinoma (RCC). One patient also experienced diarrhea while receiving off-label bevacizumab for medulloblastoma. Some patients showed lack of efficacy with certain drugs while being treated for epileptic seizures, melanoma, or NSCLC. The article provides specific details about the treatment and outcomes of several patients. [Extracted from the article]

A 33-year-old man experienced skin necrosis after receiving an incorrect administration of buprenorphine for his opioid use disorder. Instead of receiving a subcutaneous injection, he unintentionally received a dermal extended-release injection. He quickly returned to the clinic with pain and unusual skin changes, and was diagnosed with skin necrosis. The man underwent surgical removal of the buprenorphine depot, which healed without complications. It was determined that the skin necrosis was a result of a medication error. [Extracted from the article]

A 41-year-old woman developed avascular necrosis in her foot and ankle while being treated with prednisone for systemic lupus erythematosus (SLE). She had a history of SLE for 6 years and was also taking hydroxychloroquine. The woman initially received treatment for an ankle sprain, but her pain persisted and worsened. An MRI showed extensive avascular necrosis in her foot and ankle. After discontinuing prednisone and receiving rituximab, she experienced significant improvement and continued pain relief at 13 months. [Extracted from the article]

A 50-year-old man experienced tumour necrosis and tumour pseudo-progression while being treated with lenvatinib for thymic carcinoma. He initially received chemotherapy and had stable disease, but later experienced worsening symptoms. After discontinuing lenvatinib, tumour necrosis and pseudo-progression were observed, but his symptoms improved and the tumour resolved completely. Lenavatinib was restarted and the disease was well-controlled without recurrence, although the man developed other side effects. [Extracted from the article]

A 61-year-old man experienced delayed skin necrosis while undergoing antiseptic therapy with chlorhexidine. The man had prostate cancer and erectile dysfunction and had received an inflatable penile prosthesis. Three weeks after the implantation, blisters developed on his penile shaft, which progressed to full-thickness necrosis despite conservative treatment. It was determined that the chlorhexidine used during surgery was the cause of the delayed skin necrosis. The man underwent debridement and received skin autografts, resulting in 95% epithelialization without further complications. [Extracted from the article]

A 62-year-old woman developed oesophageal tumour necrosis during treatment with docetaxel, cisplatin, and fluorouracil for thoracic oesophageal squamous cell carcinoma. The woman had a history of alcoholic liver disorder, alcoholism, osteoporosis, major rosacea, smoking, and daily alcohol consumption. After neoadjuvant chemotherapy, surgery was performed to remove the tumour, but complications arose, including invasion of the botallo ligament and unexplained haemoptysis. The patient eventually recovered and was discharged after receiving radiation therapy. [Extracted from the article]

A 48-year-old man with type 2 diabetes and chronic kidney disease experienced worsening renal failure while taking ibuprofen for chronic low back pain, skin necrosis while on warfarin for deep-vein thrombosis and pulmonary embolism, and lack of efficacy with aspirin for thromboembolic event prevention. He presented with numbness, tingling, and discoloration of his fingers and toes, and later developed a nontraumatic wound on his foot. He was hospitalized with acute dyspnea and started on hemodialysis. Necrotic lesions developed on his fingers, toes, feet, and penis, and he eventually underwent amputation. He was diagnosed with arterial calcification due to a deficiency of CD73 and was treated with wound care and sodium-thiosulfate, resulting in healing of his wounds. [Extracted from the article]

A 62-year-old woman developed oesophageal tumour necrosis during treatment with docetaxel, cisplatin, and fluorouracil for thoracic oesophageal squamous cell carcinoma. The woman had a history of alcoholic liver disorder, alcoholism, osteoporosis, major rosacea, smoking, and daily alcohol consumption. After neoadjuvant chemotherapy, surgery was performed to remove the tumour, but complications arose, including invasion of the botallo ligament and unexplained haemoptysis. The patient eventually recovered and was discharged after receiving radiation therapy. [Extracted from the article]

A 48-year-old man with type 2 diabetes and chronic kidney disease experienced worsening renal failure while taking ibuprofen for chronic low back pain, skin necrosis while on warfarin for deep-vein thrombosis and pulmonary embolism, and lack of efficacy with aspirin for thromboembolic event prevention. He presented with numbness, tingling, and discoloration of his fingers and toes, and later developed a nontraumatic wound on his foot. He was hospitalized with acute dyspnea and started on hemodialysis. Necrotic lesions developed on his fingers, toes, feet, and penis, and he eventually underwent amputation. He was diagnosed with arterial calcification due to a deficiency of CD73 and was treated with wound care and sodium-thiosulfate, resulting in healing of his wounds. [Extracted from the article]

A 52-year-old man experienced severe skin necrosis while being treated with envafolimab for hepatocellular carcinoma. He also showed a lack of efficacy with donafenib, another treatment for the same condition. The man was initially diagnosed with hepatocellular carcinoma and started receiving oral donafenib and concomitant eltrombopag. After observing an anticancer effect but an increase in alpha fetoprotein levels, the lack of efficacy of donafenib was considered. He then started receiving SC injections of envafolimab, which led to the development of red plaques and necrotic skin in the injection area. The causal relationship between the skin necrosis and envafolimab was considered "probable" according to the Naranjo scale. The patient received various treatments and showed gradual improvement. [Extracted from the article]

A 64-year-old woman developed acute retinal necrosis while being treated with sintilimab for stage IIB squamous cell carcinoma of the cervix. She also experienced lack of efficacy during treatment with lobaplatin and paclitaxel for the same condition. The woman had previously received other treatments, including nedaplatin, gimeracil/oteracil/tegafur, irinotecan, cisplatin, and external radiation therapy. She underwent various antiviral and anti-inflammatory treatments for the retinal necrosis, including vitrectomy and laser photocoagulation. At the latest follow-up, her vision remained stable with the resolution of the necrotic lesion in the fundus. [Extracted from the article]

A 58-year-old woman developed anti-MDA5 antibody-positive dermatomyositis with severe necrosis on her limbs after receiving the tozinameran (Pfizer-mRNA-COVID-19 vaccine) for COVID-19. She initially presented with chilblains on her fingers, followed by joint pain and the development of ulcers with necrosis and chilblains. Despite treatment with vasodilators, antiplatelet medications, steroids, and immunosuppressants, her condition did not improve. She was diagnosed with anti-MDA5 antibody-positive dermatomyositis and is currently receiving prednisolone and tacrolimus therapy. [Extracted from the article]

A 32-year-old man developed ischaemic limb necrosis while receiving vasopressor therapy with norepinephrine and vasopressin for septic shock. The patient had a medical history of alcohol abuse, acute pancreatitis relapses, liver cirrhosis, and hypersplenism. He developed culture negative septic shock and required aggressive fluid resuscitation and vasopressor therapy. The ischaemic limb necrosis was attributed to microvascular spasms caused by the vasopressor therapy. The patient underwent amputations and received vacuum assisted closure therapy and skin graft transplantation. He was discharged after three months of hospitalization. [Extracted from the article]

A 61-year-old man developed myasthenia gravis and KLHL11-IgG rhombencephalitis while being treated with nivolumab for oesophageal adenocarcinoma. He also experienced bilateral avascular hip necrosis during treatment with prednisone. The man initially experienced double vision, dizziness, and gait instability, which were attributed to nivolumab-associated myasthenia gravis. He underwent treatment with pyridostigmine and prednisone, and his symptoms worsened over time. Further examination revealed KLHL11-IgG rhombencephalitis, and he began treatment with cyclophosphamide, which resulted in stabilization of his symptoms. His cancer remained in remission. [Extracted from the article]

A 48-year-old man experienced skin necrosis at the injection site while being treated with esmolol for non-ST-elevation myocardial infarction (NSTEMI). The man had a history of hypertension and NSTEMI and was admitted to the cardiac critical unit. After receiving peripheral IV esmolol injection for 24 hours, he developed pain, moderate edema, and bullae around the injection site. The man's condition worsened, resulting in necrosis after one week. It was determined that the skin necrosis was a result of esmolol treatment. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 57-year-old woman developed CNS varicella zoster vasculitis and acute retinal necrosis during treatment with natalizumab monthly for multiple sclerosis. She presented to the hospital with headache and visual field deficits [dosage, route, duration of treatment to reaction onset and outcome not stated]. [Extracted from the article]

A case series involving four women with drug-refractory trigeminal neuralgia (TGN) found that injection site pain, ulcer, and necrosis occurred during treatment with alcohol. One patient also experienced a lack of efficacy with other medications for TGN. The women underwent nerve blocks using alcohol injections, which initially provided pain relief but later resulted in ulcers and necrosis at the injection sites. This suggests a potential adverse reaction to alcohol injections for TGN treatment. [Extracted from the article]

A 25-year-old man experienced finger necrosis, pain, swelling, and redness at the injection site after receiving Candida antigen treatment for a cutaneous wart. He also did not respond to ibuprofen and paracetamol for the symptoms. The man sought medical attention when his symptoms worsened, and he underwent surgery to remove the affected tissue. After several weeks, the necrosis resolved completely, and the man regained full function of his finger without any pain or altered sensation. [Extracted from the article]

A 23-year-old man experienced gastroduodenal ischaemic necrosis after overdosing on clonidine, nifedipine, and olmesartan-medoxomil in a suicide attempt. The man had a history of nephrotic syndrome and a previous cerebral infarct. He presented to the emergency department with persistent abdominal pain, and physical examination revealed tenderness and rebounding pain. Diagnostic tests confirmed the diagnosis, and further treatment was refused by the patient's father. The outcome of the patient is not stated. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 51-year-old man developed genital cutaneous necrosis during chemotherapy with mitomycin [duration of treatment to reaction onset not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventIn a case series, invloving 3 men, who aged between 65-69 years, were described, who developed ischaemic skin necrosis during treatment with terlipressin for hepatorenal syndrome resulting in acute kidney injury (HRS-AKI) [routes, dosages and duration of treatment to reaction onest not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 53-year-old woman developed epidermal necrosis during treatment with methotrexate for psoriasis. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 60-year-old woman developed necrosis of pedunculated lipofibroma and exhibited lack of efficacy during treatment with paclitaxel and gemcitabine for pancreatic cancer [routes and time to reaction onset not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is: Drug overdose• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 35-year-old man developed drug-induced liver failure and hepatic necrosis due to drug-overdose following stanozolol abuse. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventIn a case report, two female patients [ages not stated] developed tissue necrosis during treatment with buprenorphine for opioid use disorder [dosages and duration of treatments to reactions onsets not stated]. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventIn a retrospective, observational study involving 148·patients treated for stroke, 4·patients [ages and sexes not stated] were described, who developed gastrointestinal bleeding (n=2), tissue necrosis (n=1) or rash (n=1) following treatment with warfarin for stroke [routes and dosages not stated]. [Extracted from the article]

A case report published in Reactions Weekly describes a patient who developed colonic necrosis and avascular necrosis of the right femoral head while being treated with zirconium silicate for hyperkalemia. The patient was admitted to the hospital with hyperkalemia and received one dose of zirconium silicate. After more than a month, a CT scan revealed avascular necrosis of the right femoral head. The relationship between the avascular necrosis and zirconium silicate was considered doubtful. [Extracted from the article]

A 69-year-old woman with an infected diabetic foot developed skin necrosis after receiving a prolonged peripheral IV infusion of norepinephrine at the wrong concentration for hypotension. She initially received the infusion for 36 hours at a rate below the maximum limit, but for longer than recommended. The concentration of the norepinephrine preparation was also higher than it should have been due to a medication error. This case highlights the importance of following proper dosing guidelines and ensuring accurate medication preparation to prevent adverse effects. [Extracted from the article]

A 67-year-old woman developed acral necrosis, characterized by black discoloration and pain in her fingers, toes, and nose, following treatment with durvalumab for recurrent non-small cell lung cancer. She had a history of lung cancer, chronic obstructive pulmonary disease, and smoking. Physical examination revealed necrosis in several fingers and toes, and laboratory tests showed elevated inflammatory markers. The woman was initially diagnosed with paraneoplastic acral vascular syndrome but was later diagnosed with acral necrosis secondary to durvalumab. Treatment with amlodipine resulted in the recovery of toe necrosis, but finger necrosis persisted. [Extracted from the article]

After 46-69 days of initiation of corticosteroids treatment, the patients developed AVN of the femoral head secondary to methylprednisolone and/or dexamethasone. An off-label corticosteroids treatment was initiated with methylprednisolone 3 × 40mg and dexamethasone 2 × 4mg (4 patients), methylprednisolone 2 × 40mg (6 patients), dexamethasone 2 × 4mg (10 patients), and methylprednisolone 2 × 40mg and dexamethasone 2 × 4mg (4 patients). [Extracted from the article]