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A rare case of angio-oedema occurred in a type 1 diabetes mellitus patient using colistin. The swelling resolved after stopping the antibiotic, suggesting a link, possibly pseudoallergy.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Immunology

Background:

  • Type 1 diabetes mellitus (T1DM) management often involves broad-spectrum antibiotics.
  • Colistin is a potent antibiotic used for multidrug-resistant Gram-negative infections.
  • Angio-oedema is a rare but serious adverse drug reaction.

Observation:

  • A 50-year-old female patient with T1DM developed angio-oedema.
  • The angio-oedema onset and resolution were temporally linked to colistin administration and discontinuation.
  • Other potential causes for angio-oedema were reasonably excluded.

Findings:

  • Colistin use was identified as a probable cause of angio-oedema.
  • Pseudoallergy is a potential mechanism for this adverse reaction.
  • Hereditary angio-oedema types 2 or 3, renal impairment, and enalapril use were considered contributing factors.

Implications:

  • This case highlights the importance of considering antibiotic-induced angio-oedema, even with rare agents like colistin.
  • Clinicians should be vigilant for angio-oedema in patients with T1DM, renal impairment, or those on ACE inhibitors like enalapril.
  • Further investigation into pseudoallergy mechanisms in antibiotic-induced angio-oedema is warranted.