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Article
May 27, 1974

Methyldopa Hyperpyrexia

Author Affiliations

St. Paul-Ramsey Hospital St. Paul

JAMA. 1974;228(9):1097. doi:10.1001/jama.1974.03230340013008
Abstract

To the Editor.—  Our Clinical Pharmacy Service has recently been consulted regarding two cases of fever of unknown origin, ultimately determined to be due to methyldopa (Aldomet). Although not a rare occurrence, this adverse drug reaction can present a confusing clinical picture. As with most drug reactions, a good medication and clinical history are essential to diagnosis.

Report of a Case.—  A 66-year-old white man suffered a blackout and absence spell, with a positive history of seizure disorder, hypertension, hyperlipidemia, and sulfonamide rash. Two weeks earlier, he had abruptly stopped taking reserpine, potassium chloride, diphenylhydantoin, and a triamterene-hydrochlorothiazide combination. Laboratory findings were as follows: Blood glucose, 150 mg/100 ml; total serum bilirubin, 1.5 mg/100 ml; total serum protein, 5.8 gm/100 ml with albumin, 3.4 gm/100 ml; and lactic dehydrogenase, 120. The blood pressure was 190/100 mm Hg. Diphenylhydantoin and methyldopa, 250 mg twice daily, were given. On the 11th day,

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