Journals / İstanbul Medical Journal / 2019 / Cilt: 20 - Sayı: 2

Palpable Purpura in a Patient with Uncontrolled Type 2 Diabetes Mellitus: Possible Side Effect of Linagliptin

Kontrolsüz Tip 2 Diabetes Mellitus’lu Bir Hastada Palpabl Purpura: Linagliptinin Muhtemel Yan Etkisi

Pages
169–171
Publication Date
2022-10-19
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

To the best of ourknowledge, our case is the first case in the literature to developpalpable purpura after linagliptin treatment.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Linagliptin is a member of “Dipeptidyl Peptidase-4” (DPP-4)inhibitors and may be preferred for certain advantages.
📊
Key Findings & Data:Wepresent a type 2 diabetes case with developed skin findingsafter initiation of linagliptin.
💡
Conclusion & Impact:To the best of ourknowledge, our case is the first case in the literature to developpalpable purpura after linagliptin treatment.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Linagliptin is a member of “Dipeptidyl Peptidase-4” (DPP-4)inhibitors and may be preferred for certain advantages. Wepresent a type 2 diabetes case with developed skin findingsafter initiation of linagliptin. A 66-year-old type 2 diabeticwoman with coronary heart disease for 10 years was admittedto our clinic with dry mouth, polydipsia and polyuria. She wason metformin, acetylsalicylic acid and nitrate treatment. Thephysical examination was unremarkable. On admission, bloodglucose was 319 mg/dL, urine ketone was negative, serumbiochemistry and arterial blood gas results were within normallimits. Linagliptin was added to treatment after glycemicregulation was achieved with intensive insulin regimen. Onthe second day of linagliptin treatment, palpable purpuralikelesions were seen in the lower and upper extremities.Linagliptin was considered as an etiological factor. Afterdiscontinuation of linagliptin, the lesions gradually regressed.DPP-4 inhibitors may lead to some dermatological side effectsdue to inhibition of other DPP enzymes. To the best of ourknowledge, our case is the first case in the literature to developpalpable purpura after linagliptin treatment.

Özet

Linagliptin, “Dipeptidil Peptidaz-4” (DPP-4) inhibitörlerinin bir üyesidir ve bazı avantajlarından dolayı tercih edilebilir. Linagliptin başlandıktan sonra deri bulguları gelişen tip 2 diyabetli bir olguyu sunuyoruz. On yıldır koroner kalp hastalığı olan 66 yaşında tip 2 diyabetli kadın hasta kliniğimize ağız kuruluğu, polidipsi ve poliüri ile başvurdu. Metformin, asetilsalisilik asit ve nitrat kullanan hastanın fizik bakısı normal sınırlardaydı. Başvuruda, kan glukozu 319 mg/dL, idrar ketonu negatif, serum biyokimya ve arteryel kan gazı normal sınırlarda saptandı. İntensif insülin rejimi ile glisemik regülasyon sağlandıktan sonra linagliptin eklendi. Linagliptin tedavisinin 2. gününde, hastanın alt ekstremitelerinde ve kollarında palpabl purpura benzeri lezyonlar ortaya çıktı. Etiyolojik faktör olarak linagliptin düşünüldü. Linagliptin kesildikten sonra lezyonlar kademeli olarak geriledi. DPP-4 inhibitörleri diğer DPP enzimlerinin inhibisyonu sebebiyle bazı dermatolojik yan etkilere yol açabilir. Bildiğimiz kadarıyla, bizim olgumuzda literatürde ilk defa linagliptin tedavisi sonrasında palpabl purpura gelişmiştir.

🔖

Cite This Article

TOPALOĞLU, Ö., ŞAHİN, İ., EVREN, B. (2022). Palpable Purpura in a Patient with Uncontrolled Type 2 Diabetes Mellitus: Possible Side Effect of Linagliptin. İstanbul Medical Journal, Cilt: 20 - Sayı: 2, 169–171. https://ajindex.com/articles/551908

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (12)

  1. Špinar J, Špinarová L, Vítovec J. The TECOS, EXAMINE and SAVOR studies--how do they differ and what are their outcomes? VnitrLek 2015
  2. Pi-Sunyer FX, Schweizer A, Mills D, Dejager S. Efficacy and tolerability of vildagliptin monotherapy in drug-naive patients with type 2 diabetes. Diabetes Res Clin Pract 2007
  3. FDA. FDA Sitagliptin. 2009. Available at http://www.fda.gov/Drugs/DrugSafety/ PostmarketDrug SafetyInformationforPatientsandProviders/ucm183768.htm. 4. Chen XW, He ZX, Zhou ZW, Yang T, Zhang X, Yang YX, et al. Clinical pharmacology of dipeptidyl peptidase 4 inhibitors indicated for the treatment of type 2 diabetes mellitus. Clin Exp Pharmacol Physiol 2015
  4. Gabrilovac J, Čupić B, Zapletal E, Kraus O, Jakić-Razumović J. Dipeptidylpeptidase 9 (DPP9) in human skin cells. Immunobiology 2017
  5. 222 327-42. 6. Eckhardt M, Langkopf E, Mark M, Tadayyon M, Thomas L, Nar H, et al. 8-(3-(R)- aminopiperidin-1-yl)-7-but-2-ynyl-3-methyl-1-(4-methyl-quinazolin-2-ylme thyl)-3,7-dihydropurine-2,6-dione (BI 1356), a highly potent, selective, longacting, and orally bioavailable DPP-4 inhibitor for the treatment of type 2 diabetes. J Med Chem 2007
  6. Deacon CF, Holst JJ. Linagliptin, a xanthine-based dipeptidyl peptidase-4 inhibitor with an unusual profile for the treatment of type 2 diabetes. Expert Opin Investig Drugs 2010
  7. Psomadakis C, Shahzad N, Katz J. Linagliptin-associated blistering and ulceration. BMJ Case Rep 2017
  8. pii: bcr-2017-219998. 9. Vilsboll T, Rosenstock J, Yki-Jarvinen H, Cefalu WT, Chen Y, Luo E, et al. Efficacy and safety of sitagliptin when added to insulin therapy in patients with type 2 diabetes. Diabetes Obes Metab 2010
  9. Covington P, Christopher R, Davenport M, Fleck P, Mekki QA, Wann ER, et al. Pharmacokinetic, pharmacodynamic, and tolerability profiles of the dipeptidyl peptidase-4 inhibitor alogliptin: A randomized, double-blind, placebo-controlled, multiple-dose study in adult patients with type 2 diabetes. Clin Ther 2008
  10. Nauck M, Ellis G, Fleck P, Wilson C, Mekki Q
  11. Alogliptin Study 008 Group. Efficacy and safety of adding the dipeptidyl peptidase-4 inhibitor alogliptin to metformin therapy in patients with type 2 diabetes inadequately controlled with metformin monotherapy: a multicentre, randomised, double-blind, placebo-controlled study. Int J Clin Pract 2009
  12. Attaway A, Mersfelder TL, Vaishnav S, Baker JK. Bull