A Case Report of One Patient with Allergic Purpura Induced by Voriconazole

  • Zhihong Qiu Department of Pharmacy, Hebei general hospital, Hebei, Shijiazhuang, 050051, China
  • Benquan Qi Department of Pharmacy, the first Affiliated Hospital of Bengbu Medical College, Anhui, Bengbu 233004, China
  • Hongtao Liu Department of Pharmacy, Hebei general hospital, Hebei, Shijiazhuang, 050051, China
  • Lien He Department of Pharmacy, Hebei general hospital, Hebei, Shijiazhuang, 050051, China
  • Yinling Ma Department of Pharmacy, Hebei general hospital, Hebei, Shijiazhuang, 050051, China
  • Haojing Song Department of Pharmacy, Hebei general hospital, Hebei, Shijiazhuang, 050051, China
  • Meiling Yu Department of Pharmacy, the first Affiliated Hospital of Bengbu Medical College, Anhui, Bengbu 233004, China

Abstract

Voriconazole is a second-generation triazole antifungal drug, which exhibits characteristics of wide antibacterial spectru, high biological utilization and passing through plasma brain barrier. The most common adverse reactions of voriconazole include neurological dysfunction, visual disturbance, abnormal liver function and renal dysfunction, here, this is the report to show that voriconazole can induce allergic purpura. The present report mainly describes one patient with rare adverse reactions, namely mixed type allergic purpura induced by high concentration of plasma drug caused by slow metabolism of voriconazole. Aafter using voriconazole, the patient was diagnosed as mixed type allergic purpura, methylprednisolone sodium succinate was given for treatment. After treatment, abdominal pain and abdominal distension of the patient was significantly alleviated, and the color of rash faded. Edemas of both lower extremities were significantly improved, and the color of stool turned into yellow. The measured concentration of plasma drug of voriconazole was 15 μg/ml on admission of the patient. Genetic testing result demonstrated that the patient belonged to heterozygous mutation of CYP2C19*1*2, and the metabolism of voriconazole of the patient was relatively slow. The report prompted the clinicians that there were significant metabolic differences of voriconazole in different populations. Therefore, monitoring of drug concentration should be conducted timely in the clinical application to reduce the risk of medication and achieve individualized administration.

Published
2017-07-06