Erythropoietin Induced Miliaria Crystallina: A Possible New Adverse Effect of Erythropoietin

Introduction: Erythropoietin, also known as EPO, is used for the treatment of anemia of chronic kidney disease. Usually, the drug is well tolerated with only a few side effects. Adverse effects are mostly systemic with hypertension being seen frequently. Various cutaneous side effects include pruritus, rash, urticaria and erythema. However, miliaria induced by erythropoietin has not been reported so far. Case Report: A 74-year-old female was referred from medicine department with possibility of toxic epidermal necrolysis. She developed crops of non-itchy tiny vesicles filled with clear fluid on body for the last three days. Injection erythropoietin was given six hours prior to onset of rash. Similar episode occurred one week back after the use of erythropoietin. There was no history of any acute febrile illness. She was a known case of hypertension, diabetes mellitus with chronic kidney disease. There was no change in the treatment plan for the above mentioned complaints except introduction of erythropoietin recently for the management of severe anemia secondary to chronic kidney disease. The diagnosis of miliaria crystallina was made clinically and spontaneous resolution occurred in about seven days. Conclusion: This case adds erythropoietin among the list of drugs precipitating miliaria crystallina which is being reported for the first time in literature. Recognizing this otherwise benign clinical entity is important as it can be confused with severe drug reactions such as toxic epidermal necrolysis. The absence of inflammatory signs in skin, lack of mucosal involvement, no systemic manifestations and spontaneous resolution can help to distinguish it from other drug reactions.

並列關鍵字

Erythropoietin ； EPO ； Miliaria ； Eccrine sweat glands

國際替代計量

全文下載

主題瀏覽