- 期刊
Vildagliptin引起嚴重皮膚過敏反應之案例報告
Vildagliptin Induced Severe Allergic Skin Reaction: A Case Report
摘要
Vildagliptin是一種口服雙肽基胜肽酶-4（Dipeptidyl peptidase 4，DPP-4）抑制劑，透過增加腸促胰素荷爾蒙濃度，具有改善血糖的控制，用於第二型糖尿病患者。常見臨床的不良反應包括鼻咽炎、上呼吸道感染、頭痛、腸胃道症狀、肌肉骨骼症狀。本案例是報告一位79歲男性糖尿病患者，因為使用vildagliptin而導致嚴重皮膚過敏反應。由於藥物不良反應發生的時間呈現相關聯性，症狀包括全身皮膚紅疹、水泡、皮膚脫屑，皆於使用vildagliptin後出現。然而，DPP-4抑制劑導致嚴重皮膚過敏反應的機轉尚未很清楚，推測可能與調節免疫功能有關。雖然vildagliptin引起的嚴重皮膚過敏反應並不常見，但對於使用這些藥物的病人仍應提供適當的照護，醫護人員亦應警覺可能發生的不良反應，定期監測藥物使用的情況。
並列摘要
Vildagliptin is an orally active inhibitor of the dipeptidyl peptidase 4 (DPP-4) enzyme, which improves glycaemic control in patients with Type 2 diabetes mellitus (T2DM) by enhancing levels of active incretin hormones. Common reported clinical adverse events with vildagliptin are nasopharyngitis, upper respiratory infections, headache, gastrointestinal symptoms and musculoskeletal pain. We reported a 79-years man who developed severe allergic skin reaction after vildagliptin treatment for T2DM. The consequential adverse reactions, including body of skin rash, blisters, and skin desquamation after drug treatment suspected to be related to a DPP-4 inhibitor, vildagliptin. Although the mechanism is not clear, we speculated that it could modulate immune function. The previous reports related to DPP-IV induced severe allergic skin reaction were rare, however, we still suggest that clinicians should provide appropriate care for patients with vildagliptin treatment, aware the possibilities of vildagliptin-induced adverse reactions, and monitor the usage of these kind of drugs periodically.
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