Omeprazole Induced Rapid Drug Reaction with Eosinophilia, Systemic Symptoms, and Cross-Reactivity in Delayed-Type Hypersensitivity Associated with Proton-Pump Inhibitors: A Case Report and Literature Review
Issued Date
2024-01-01
Resource Type
ISSN
20906609
eISSN
20906617
Scopus ID
2-s2.0-85182554361
Journal Title
Case Reports in Immunology
Volume
2024
Rights Holder(s)
SCOPUS
Bibliographic Citation
Case Reports in Immunology Vol.2024 (2024)
Suggested Citation
Pinyopornpanish K., Pinyopornpanish K., Pinyopornpanish K., Benjanuwattra J., Teepapan P., Chungcharoenpanich A., Laisuan W. Omeprazole Induced Rapid Drug Reaction with Eosinophilia, Systemic Symptoms, and Cross-Reactivity in Delayed-Type Hypersensitivity Associated with Proton-Pump Inhibitors: A Case Report and Literature Review. Case Reports in Immunology Vol.2024 (2024). doi:10.1155/2024/1317971 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95910
Title
Omeprazole Induced Rapid Drug Reaction with Eosinophilia, Systemic Symptoms, and Cross-Reactivity in Delayed-Type Hypersensitivity Associated with Proton-Pump Inhibitors: A Case Report and Literature Review
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Corresponding Author(s)
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Abstract
Background. Omeprazole, a proton pump inhibitor (PPI), is a widely used and generally safe agent for treating acid-related gastrointestinal conditions. However, drug reaction with eosinophilia and systemic symptoms (DRESSs) syndrome has been reported. Objectives. To report a case of omeprazole-induced rapid DRESS syndrome and to review the literature. Methods. Descriptive analysis of one new case and a case series from literature review. Results. We report a case of 82-year-old woman presenting with rapid-onset of DRESS syndrome. The condition was initially suspected to be caused by antibiotic, but the definite diagnosis was eventually omeprazole-induced DRESS syndrome as suggested by the enzyme-linked immune absorbent spot (ELISpot) assay along with the clinical picture. Previous literatures regarding cases of PPI-induced DRESS syndrome were pooled for descriptive analysis. Among 21 PPI cases pooled, esomeprazole was the most commonly implicated PPI (52.4%), followed by pantoprazole (19.1%), and omeprazole along with lansoprazole (both 14.3%). The issue of cross-reactivities amongst PPIs remains uncertain. Nonetheless, in situations in which a PPIs are deemed necessary, a prudent approach could be considering a switch to an alternative agent with distinct chemical structure. Conclusion. PPI is commonly used safely as an agent for acid-related gastrointestinal conditions. However, PPI-induced rapid DRESS syndrome can occur, particularly with prior exposure history. ELISpot is an in vitro test, useful in identifying the culprit agent in patients with delayed-type hypersensitivity reaction.