ECE2015 Eposter Presentations Clinical Cases–Thyroid/Other (101 abstracts)
Two cases of bullous pemphigoid induced by vildagliptin
Asli Dogruk Unal , Ozlem Tarcin , Gulsen Tukenmez Demirci , Ebru Demiralay , Ayse Tulin Mansur , Semsi Yildiz & Nilgun Guvener Demirag
Baskent University Hospital, Istanbul, Turkey.
Background: Bullous pemphigoid is an autoimmune blistering disease that commonly arise in elderly with increased risk for mortality and morbidity. The aetiology of this disease is not entirely clear, although a few cases have been described with dipeptidyl peptidase IV inhibitors.
Case 1: A 81-year-old man presented with bullous pemphigoid after 28-month treatment with repaglinide, vildagliptin, and metformin. The patient’s condition didn’t improve with local treatment with clobetasol. The patient was started on methylprednisolone and azathiopurine but skin lesions sustained. Remission was achieved only after withdrawal of gliptin.
Case 2: A 64-year-old man treated with insulin glargine, insulin aspart, and vildagliptin for 12 months presented with bullous pemphigoid on skin and laryngeal mucosa. After discontinuation of vildagliptin skin lesions were resolved but laryngeal involvement continued. Mucosal lesions were resolved after methyprednisolone and azothiopurine treatment.
Conclusion: In the literature, there have been few cases descibed with gliptins. The exact mechanism has not been known but believed to be modified immune responses. These reports support the risk of bullous pemphigoid in patients exposed to gliptins. The difference of our cases from the literature is mucosal involvement and remission of our cases only with immunosuppressive agents.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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