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[Maculopapular exanthema during diltiazem therapy].

R Hammentgen¹, G Lutz, U Köhler

¹Medizinische Universitätsklinik, Innere Medizin-Kardiologie, Bonn.

Deutsche Medizinische Wochenschrift (1946)

|August 19, 1988

Summary

Diltiazem, a calcium antagonist, caused a severe allergic skin reaction (maculopapular exanthema) in a patient with coronary heart disease. Allergy tests confirmed diltiazem as the cause, and symptoms resolved after discontinuing the drug.

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Area of Science:

Cardiology
Dermatology
Clinical Pharmacology

Background:

Coronary heart disease management often involves calcium antagonists like diltiazem for angina.
Drug-induced hypersensitivity reactions can manifest with various dermatological symptoms.

Observation:

A 60-year-old male patient with coronary heart disease developed a maculopapular exanthema during diltiazem treatment for angina.
The patient exhibited positive results for both immediate (Type I) and delayed (Type IV) hypersensitivity reactions upon testing with diltiazem.

Findings:

The maculopapular exanthema was definitively linked to diltiazem as the causative agent.
Discontinuation of diltiazem led to the rapid resolution of the exanthema.
Alternative anti-anginal therapy with nifedipine was well-tolerated, with no recurrence of adverse events.

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Implications:

This case highlights the potential for diltiazem to induce both immediate and delayed hypersensitivity reactions.
Clinicians should consider drug-induced exanthema in patients presenting with skin reactions during diltiazem therapy.
Alternative calcium antagonists, such as nifedipine, may be suitable for patients with documented diltiazem hypersensitivity.