Case study: 55-year-old patient with body swelling and rash after pantoprazole administration

Abstract

A 55-year-old patient presented with generalized body swelling and a rash after initiating Pantoprazole 40 mg for gastrointestinal concerns. The patient had no prior history of hypertension, diabetes mellitus, or significant comorbidities. The rash was erythematous, pruritic, and maculopapular, while generalized pitting edema was noted in the face, legs, and hands. A thorough examination ruled out systemic infection and suggested a drug-induced hypersensitivity reaction, with possible angioedema. The differential diagnosis included viral exanthem and autoimmune disorders. Investigations were conducted to assess the extent of the reaction, including blood tests, renal and liver function tests, and a potential skin biopsy. Management focused on discontinuing Pantoprazole, symptomatic treatment with antihistamines, corticosteroids, and diuretics, and close monitoring for progression. The patient's prognosis was favourable upon discontinuation of the drug, with most symptoms resolving in a few weeks. Patient education included avoiding re-exposure to Pantoprazole and scheduling follow-up appointments to monitor symptom resolution. This case highlights the importance of recognizing drug-induced hypersensitivity reactions, particularly with commonly prescribed medications like Pantoprazole, and providing timely management to prevent complications.