Hypersensitivity to repaglinide

J Investig Allergol Clin Immunol. 2011;21(3):245-7.

Abstract

Meglitinides (repaglinide and nateglinide) are insulin secretagogues used to treat diabetes mellitus. We present a case of hypersensitivity reaction to repaglinide in a 61-year-old man who developed a maculopapular rash 5 days after treatment. Skin prick tests including repaglinide (0.5 g/mL) and patch tests (0.05% in pet and saline) were performed, and the results were negative. A blind oral challenge test with repaglinide was performed and the therapeutic dose was subsequently taken at home every 24 hours for 7 days. The result was positive with a delayed reaction at day 3. A punch biopsy of the skin lesions revealed drug-induced exanthema. The clinical manifestations, the latency period, the reappearance of cutaneous lesions after rechallenge, and the histopathology report of the skin biopsy suggest a type IV mechanism.

Publication types

  • Case Reports

MeSH terms

  • Carbamates / adverse effects*
  • Carbamates / immunology*
  • Carbamates / therapeutic use
  • Cyclohexanes / therapeutic use
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / immunology
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / etiology*
  • Drug Hypersensitivity / immunology
  • Erythema / immunology
  • Erythema / pathology
  • Exanthema / chemically induced*
  • Exanthema / immunology
  • Exanthema / pathology
  • Humans
  • Hypoglycemic Agents / adverse effects*
  • Hypoglycemic Agents / immunology
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Nateglinide
  • Patch Tests / methods
  • Phenylalanine / analogs & derivatives
  • Phenylalanine / therapeutic use
  • Piperidines / adverse effects*
  • Piperidines / immunology*
  • Piperidines / therapeutic use

Substances

  • Carbamates
  • Cyclohexanes
  • Hypoglycemic Agents
  • Piperidines
  • Nateglinide
  • Phenylalanine
  • repaglinide