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Tom 11, Nr 3 (2016)
Praca badawcza (oryginalna)
Opublikowany online: 2016-07-13

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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Dermatological adverse effects of heart medicine. A retrospective study of patients in a dermatological ward in Gdansk between years 2004-2013 and review of the literature.

Paulina Flis, Dorota Mehrholz, Wioletta Barańska-Rybak, Roman Nowicki
Folia Cardiologica 2016;11(3):186-193.

Streszczenie

A wide range of medications are used in cardiological medicine. The treated population is often elderly with polypharmacy. The treatment sometimes comes with adverse effects and these patients can be met in all hospital wards. We analyzed medical charts of all patients admitted to Department of Dermatology, Allergology and Venerology at Medical University of Gdansk between years 2004-2013. The aim was to investigate the demographics as well as skin manifestations, abnormalities in laboratory results and treatment. 29 cases were found with hypersensitivity reactions manifested on the skin due to different drugs used in cardiology. The manifestations were diverse. Most presented as urticaria with or without accompanying angioedema (11), pemphigoid changes (9) and non-urticarial maculopapular exanthema (6). One patient presented with Steven Johnsons Syndrome (SJS) and two patients were diagnosed with vasculitis. The causative drugs were angiotensin converting enzyme inhibitors, loop-diuretics, calcium channel inhibitors, Metoprolol, statins, acetylsalicylic acid, Ticlopidine, Molsidomin, Doxazosin and Enoxaparin. In our study we present three reactions not yet described in literature; bullous pemphigoid after Torasemide and Quinalapril and SJS after Enalapril. The treatment of all patients consisted of discontinuation of suspected drug and in all exept one medical therapy was required. In the patients with urticaria, anaphylaxis and maculopapular exanthema, oral glucocorticosteroids and oral antihistamines were given with good effect. The diagnosis of pemphigoid resulted in additional immunosuppressive treatment with adjuvant drugs. All patients recovered within a week without any sequelae. Quick diagnosis of the hypersensitivity reaction and identification of the culprit drug is crucial for the patient. It is important to have a good communication between internal medicine doctors and dermatologist to suceed in treatment of both the dermatological pathology and to plan further cardiological treatment. Although cardiological drugs are commonly used we could find a few hypersensitivity reactions due to this group of medications, compared to all patients admitted due to adverse drug reactions during the time studied.