Immune system

A global meta-analysis found 1.5% of the general population tested positive for celiac antibodies and 0.8% had celiac disease confirmed by biopsy.

The label reports systemic allergic reactions in 0.5% of adults in trials and injection site reactions in 0.5% against 0% on placebo, with postmarketing anaphylaxis.

One trial reported one allergic event in the garden among 145 people given a community garden plot.

The label warns of serious rash, including Stevens-Johnson syndrome. In children's trials 0.8% stopped for rash, against none on placebo. Modafinil is not approved for children.

A national survey estimated convincing soy allergy in 0.6% of US adults.

A national survey estimated convincing wheat allergy in 0.8% of US adults.

The label warns of serious and sometimes fatal skin reactions in about 5 in 10,000 people, with higher risk in carriers of the HLA-B*58:01 gene.

The cimetidine label reports low white cell counts in about 1 per 100,000 patients and agranulocytosis in about 3 per million, mostly in seriously ill people on other drugs.

The label reports multiorgan hypersensitivity reactions, some fatal, and deaths from organ or liver failure in 2 of 3,796 adults and 4 of 2,435 children in trials.

The label reports agranulocytosis in 2 of 2,796 people in premarketing trials, and severe neutropenia in a third. All three recovered after stopping.

Linked to resistant bacteria in the person treated, about 2.5 times the odds within 2 months for urinary bacteria, lasting up to 12 months.

The labels warn of serious, occasionally fatal allergic reactions. In proven penicillin allergy, cross-reaction to cephalosporins ranged from 2% to 16%, highest with a shared side chain.

Shown to raise CRP in adults across 14 studies. Sources disagree on oxidative stress, with one marker rising and another falling.

Garlic breath and body odor were the most common complaints in trials. Case reports describe allergic reactions and skin burns from fresh garlic.

Linked to about 2.9 times the odds of Stevens-Johnson syndrome or toxic epidermal necrolysis on lamotrigine in people carrying HLA-B*1502, mostly studied in Asian populations.

Shown to cut cyclosporine levels about half in kidney transplant patients with a high-hyperforin extract. Two heart transplant patients had acute rejection from the interaction.

Linked to about twice the odds of Lyme disease antibodies in outdoor workers, and 2.4 times in forestry and farm workers, in one meta-analysis.

Limited evidence: EMS-like symptoms have been linked to 5-HTP, and contaminants called peak X were found in tested products. Sources disagree on whether peak X matters.

The label warns that acetaminophen may rarely cause serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, which can be fatal.

Case reports: infections were the most common complication in 294 published acupuncture adverse event cases from 2000 to 2011, mostly bacterial.

The label warns that allopurinol raises exposure to azathioprine and mercaptopurine, which can suppress the bone marrow.

Case reports: six adults had episodes of low blood sugar 30 to 120 days after starting 600 mg a day, which eased after stopping.

The label warns that aspirin may cause severe hives, swelling or bronchospasm in people with the syndrome of asthma, rhinitis and nasal polyps.

Case reports: four laboratory workers developed allergy to bromelain, mostly from breathing it in. No count exists for people taking it by mouth.

The labels report that people sensitized to the clonidine patch may develop a widespread rash, hives or swelling when switched to clonidine tablets. They give no rate.

An outbreak investigation linked at least 36 cases of amebiasis to colonic irrigation at one clinic, where the machine stayed contaminated after routine cleaning.

Case reports: burns, blisters, lasting skin discoloration, scars and infections after cupping, and rare bleeding inside the skull after cupping on the scalp.

Case reports: rare allergic reactions, which may be severe. Gastrointestinal upset and rash were the most frequent adverse events reported.

Self-reported egg allergy ranged from 0.2% to 7% across studies, in a meta-analysis that found objective tests gave far lower figures than self-report.

One trial found that, in a post hoc subgroup, flu symptoms were 2 days worse on elderberry alone than on placebo alone.

Case reports: two people had severe immediate allergy to fenugreek with wheezing, and both also reacted to chickpea.

Case reports: a woman died of anaphylaxis after taking a psyllium product. Workers who handle psyllium can become sensitized.

One trial found quercetin shifted inflammatory proteins in a pro-inflammatory direction in women after bypass surgery, and the opposite in men.

The label warns of angioedema and anaphylaxis with both drugs, and of a multiorgan hypersensitivity reaction with gabapentin that has been fatal. It gives no rate.

Case reports: glucosamine products drew the most supplement reports in Singapore, mainly rash, itching, hives and swelling.

The FDA states grapefruit juice can interact with cyclosporine. Small trials found higher cyclosporine exposure in volunteers and higher tacrolimus levels in liver transplant patients.

The FDA states grapefruit juice can cause less fexofenadine to enter the blood. In one trial, 300 mL cut its exposure to 58% of that with water.

Case reports: 38 reports described harms in 1,159 people, including four deaths, from remedies themselves or from homeopathy replacing conventional care.

The label warns hydroxyzine may rarely cause acute generalized exanthematous pustulosis, a serious rash with fever and pustules. It gives no rate.

The label reports severe, life-threatening generalized allergy including anaphylaxis with insulin, and redness, itching and swelling at injection sites. It gives no rate.

Case reports: the label describes Stevens-Johnson syndrome and toxic epidermal necrolysis after approval, some fatal. One case led to withdrawal in trials.

Case reports: previously healthy women developed bloodstream infections with environmental bacteria after IV vitamin infusions given outside hospitals, one of them nearly fatal.

The label reports a life-threatening immune overactivation syndrome in children and adults, starting 8 to 24 days after lamotrigine was begun. It gives no rate.

The label reports low white cells, low platelets, anemia and, rarely, aplastic anemia, with or without a hypersensitivity reaction. It gives no rate.

The label states lamotrigine raises the risk of aseptic meningitis, with symptoms starting 1 day to 6 weeks after it was begun and returning quickly on restarting.

Limited evidence: injection-site redness, itching and bleeding were reported with GLP-1 drugs, rising with dose. Liraglutide-specific rates were not given.

The label reports severe skin reactions after mirtazapine, including drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome and toxic epidermal necrolysis. It gives no rate.

The label reports systemic eosinophilia, sometimes with vasculitis consistent with Churg-Strauss syndrome, often as oral steroids were reduced. A causal link has not been established.

Limited evidence: at antidote doses for acetaminophen poisoning, acetylcysteine has caused reactions from nausea to death, and intravenous dosing anaphylaxis-like reactions.

One trial found more serious gut, muscle, skin, infection and bleeding events with niacin plus laropiprant. EMA suspended these products in 2013.

Case reports: 27 people had allergic acute coronary events after diclofenac, mostly coronary spasm, and all survived to discharge.

The label reports anaphylaxis and bronchospasm, including in people allergic to other drugs of the same class. It gives no rate.

Linked to more sepsis and blood clots in the 30 days after starting a short course, with rate ratios of 5.30 and 3.33.

One study of 80 patients found prednisone raised the white blood cell count, in some above 20,000 per cubic millimeter, mainly through neutrophils.

Case reports: eight cases of infection of the disc and spine after oxygen-ozone therapy, one of them fatal.

Case reports: bloodstream infections matching the product strain occurred in ICU patients and 32 preterm infants, two of whom died.

The label warns of severe skin reactions and of cutaneous and systemic lupus reported with proton pump inhibitors, mostly cutaneous lupus. It gives no rate.

The label warns immunosuppression may increase infection and the possible development of lymphoma and other malignancies, at transplant doses.

Limited evidence: statins appeared in 9% of FDA autoimmune hepatitis reports, strongest for fluvastatin. Spontaneous reports cannot give a rate or prove cause.

The label reports Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS, anaphylaxis and angioedema with topiramate. It gives no rate.

Case reports: one severe allergic reaction occurred in the tablet trials, and anaphylactic shock has been reported after an intravenous dose.

Case reports: the adapalene label lists anaphylaxis, swelling of the face, eyelids and lips, and itching after approval. The tretinoin label calls true contact allergy rare.

The label warns of angioedema of the tongue, glottis or larynx after first or later doses of sedative hypnotics including zolpidem. It gives no rate.