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Possible montelukast-induced angioedema.
Racha Sabbagh1, Marwan Sheikh-Taha
1School of Pharmacy, Lebanese American University, Byblos, Lebanon.
Summary
A woman experienced recurrent angioedema episodes shortly after starting montelukast. Discontinuation of montelukast led to symptom resolution, suggesting a potential drug-induced adverse event.
Area of Science:
- Clinical Medicine
- Pharmacology
- Allergy and Immunology
Background:
- Angioedema is a potentially life-threatening condition characterized by swelling in the deeper layers of the skin.
- Leukotriene receptor antagonists, such as montelukast, are commonly prescribed for allergic conditions.
- Recurrent angioedema necessitates a thorough investigation into potential triggers, including iatrogenic causes.
Observation:
- A 46-year-old female with a history of allergies and angioedema presented with acute angioedema symptoms including jaw tightness, facial numbness, and dyspnea.
- The patient reported four episodes of angioedema within one month of initiating montelukast therapy.
- Symptoms recurred approximately five days after starting montelukast and resolved after its discontinuation.
Findings:
- The temporal association between montelukast initiation and recurrent angioedema episodes strongly suggests a drug-induced adverse reaction.
- Despite a history of allergies, no other medication or dietary changes correlated with the angioedema episodes.
- Immediate treatment with epinephrine and subsequent stabilization with antihistamines were administered.
Implications:
- This case highlights the importance of considering montelukast as a potential cause of drug-induced angioedema, even in patients with pre-existing allergic conditions.
- Clinicians should maintain a high index of suspicion for medication side effects in patients presenting with recurrent angioedema.
- Discontinuation of the suspected agent is a crucial step in managing and diagnosing drug-induced angioedema.
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