Nonthrombocytopenic purpura associated sequentially with nifedipine and diltiazem.
OBJECTIVE
To report the case of a patient who developed nonthrombocytopenic purpura sequentially following the administration of nifedipine and diltiazem.


METHODS
Case reports, MEDLINE review of pertinent literature, and review of relevant studies.


METHODS
Data were extracted from direct patient observation and review of laboratory studies and published reports.


RESULTS
Nonthrombocytopenic purpura secondary to cutaneous vasculitis is a known, although rare, adverse effect of nifedipine. It has not been reported in association with diltiazem. We report the case of a 75-year-old woman in whom a purpuric rash demonstrated by biopsy to be attributable to cutaneous vasculitis developed in the course of nifedipine therapy. The rash disappeared after discontinuation of the drug; however, it recurred when diltiazem therapy was initiated.


CONCLUSIONS
Nonthrombocytopenic purpura may be associated with diltiazem as well as with nifedipine. When this adverse effect occurs following administration of a calcium-channel blocker, caution is advised in using other agents of the same class.
Kuo
M
M
Department of Medicine, St. Joseph Hospital and Health Care Center, Chicago, IL 60657.
Winiarski
N
N
Garella
S
S
D000368:Aged; D004110:Diltiazem / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000139:chemically induced*; D009543:Nifedipine / Q000009:adverse effects*; D012008:Recurrence; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000150:complications
D004110:Diltiazem; D009543:Nifedipine