Exanthematous drug eruption due to valsartan

Öztürk, Gökçen Kartal; Türk, Bengü Gerçeker; Senturk, Bircan; Türkmen, Mutlu; Kandıloğlu, Gülşen

doi:10.3109/15569527.2011.647179

Cited by 10 publications

(5 citation statements)

References 8 publications

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“…Lichenoid, maculo-papular or pityriasis rosea-like reactions to ACE-inhibitors or sartans have been described in the literature 3,4,[6][7][8][9][10][11] . In most cases, a latency period of few days up to 3 weeks has been reported in such rashes supporting the possible role of cell-mediated hypersensitivity mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Eczematous reactions due to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers

Veña

Cassano

Coco

et al. 2013

Immunopharmacology and Immunotoxicology

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Cutaneous adverse drug reactions (ADRs) to antihypertensive drugs have been frequently reported. We describe a peculiar clinical pattern of cutaneous ADR, represented by an eczematous reaction induced by certain antihypertensive drugs that we observed in elderly patients. The case series consisted of 23 hypertensive patients aged 66-87 years; 19 of them were taking another drug in addition to the suspected antihypertensive medication and 15 were on polytherapy with three or more drugs to treat multiple comorbidities. The antihypertensive culprit agents were angiotensin-converting enzyme (ACE) inhibitors in 9 patients, ACE-inhibitors combined to hydrochlorothiazide (HCT) in 7 subjects, angiotensin II receptor blockers alone in 2 patients and associated with HCT in 5 cases. The cutaneous ADR was characterized by an eczematous rash that was generalized in 16 patients and localized in 7 cases, with predominant involvement of lower limbs. Such lesions developed after a latency of 4-30 months and were associated with moderate-to-severe itch, usually unresponsive to oral antihistamines. Histopathological diagnosis was available for 9 cases, confirming the presence of a spongiotic dermatitis with possible associated psoriasiform skin changes.

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Section: Discussionmentioning

confidence: 99%

Eczematous reactions due to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers

Veña

Cassano

Coco

et al. 2013

Immunopharmacology and Immunotoxicology

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“…There are few reports of skin reactions induced by ARBs, with losartan and valsartan being the most frequent culprits [1] . Two cases due to irbesartan have been described in the literature: one case of multiform erythema with a positive LTT [2] and one lichenoid eruption with a positive patch test [3] .…”

Section: Discussionmentioning

confidence: 99%

“…It is prescribed for controlling hypertension, as well as for treating heart failure and preventing kidney failure in diabetic and hypertensive patients. Cutaneous side effects to ARB are uncommon [1] . Some have been described, but the mechanisms remain poorly defined in most cases.…”

Section: Introductionmentioning

confidence: 99%

Late-Onset Rash from Irbesartan: An Immunological Reaction

Cardoso

Martins

Farinha

et al. 2019

European Journal of Case Reports in Internal Medicine

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Cutaneous delayed reactions to antihypertensive drugs have been described in a limited number of case reports but the mechanisms remain mostly unknown. We report the case of a 60-year-old female patient with a 3-week history of an itchy erythematous maculopapular eruption. Although the patient was polymedicated, irbesartan was the most likely culprit. Patch tests and a lymphocyte transformation test to irbesartan were both positive, which was useful for diagnosis and suggested an immunological reaction. No new lesions appeared after irbesartan was stopped or after the introduction of candesartan. Despite its similar chemical structure, candesartan may be tried in patients allergic to irbesartan. LEARNING POINTS Irbesartan can induce immunological cell-mediated skin reactions. Allergy to irbesartan does not imply a class allergy. Patch tests and a lymphocyte transformation test were useful in the diagnosis of irbesartan allergy.

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“…Losartan, which is the 1st marketed ARB, has been reported to cause lymphoid hyperplasia, [8] vasculitis, [9] and angioneurotic edema [10] in literature. Valsartan-associated allergy is similar to losartan including drug eruption, [11–14] angioedema [15–20] and mucocutaneous bullous pemphigoid [21] (Table 1). Drug eruption of valsartan is relatively common in clinic and usually start after weeks to 1 month of therapy.…”

Section: Discussionmentioning

confidence: 99%

Severe acute interstitial nephritis induced by valsartan

Chen

et al. 2019

Medicine

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Rationale: Angiotensin receptor blocker (ARB) can increase serum creatinine or potassium levels in patients with renal insufficiency, renal artery stenosis, heart failure or hypovolemia, but hardly cause severe kidney injury in patients without any risk factors. A case of severe acute interstitial nephritis (AIN) induced by valsartan was reported here. Patient concerns: A 62-year-old female with nausea for 1 month and acute deterioration of kidney function for 2 weeks was admitted. She had a history of hypertension for 5 months and had taken valsartan 40 mg daily for 4 months. Although the valsartan had been stopped for 2 weeks, the serum creatinine continuously increased after admission. Kidney biopsy demonstrated the eosinophils infiltration in interstitium. Diagnoses: AIN induced by valsartan. Interventions: The patient was treated with glucocorticoid. Outcomes: The serum creatinine decreased gradually and got back to normal level 5 months later. Then therapy of glucocorticoid was stopped. Renal artery stenosis was excluded by computed tomography angiography (CTA). Lessons: Although valsartan-induced allergy has been reported previously, AIN was firstly recognized as a severe complication of this drug. We suggest when there is a ARB-associated continuous deterioration of kidney function for patients without renal insufficiency, renal artery stenosis, heart failure or hypovolemia, AIN should be thought of and therapy with glucocorticoid should be considered if necessary.

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Exanthematous drug eruption due to valsartan

Cited by 10 publications

References 8 publications

Eczematous reactions due to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers

Eczematous reactions due to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers

Late-Onset Rash from Irbesartan: An Immunological Reaction

Severe acute interstitial nephritis induced by valsartan

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