[Fluindione-induced acute exanthematous pustulosis with renal involvement].
BACKGROUND
Fluindione (Previscan) is an oral anti-vitamin K anticoagulant, widely prescribed in France. Contrary to phenindione, which is also an indanedione derivative, very few cases of immunoallergic reactions have been described.


METHODS
A 68 year-old man, treated with fluindione for cardiac arrhythmia, presented with a pustular eruption and erythema twenty days after initiation of treatment. The eruption was associated with hyperthermia, arthralgia, neutrophilia (11,000/mm2), hepatic cytolysis and renal involvement including acute renal failure, hematuria and proteinuria. In view of the absence of any earlier case in the literature, we did not impute fluindione and the drug was reintroduced and led to the rapid recurrence of all the same manifestations.


CONCLUSIONS
These manifestations were consistent with an immunoallergic reaction to fluindione (probable intrinsic imputability I3) and acute interstitial nephritis (probable intrinsic imputability I3). We believe this is the first case of acute generalized exanthematous pustulosis induced by fluindione (intrinsic imputability Bo). A few rare cases of fluindione-induced hypersensitivity reactions and acute interstitial nephritis, however, have been described.
Thurot
C
C
Service de Dermatologie, CHU Michallon, 38043 Grenoble 09.
Reymond
J-L
JL
Bourrain
J-L
JL
Pinel
N
N
Beani
J-C
JC
D000208:Acute Disease; D000368:Aged; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D003875:Drug Eruptions / Q000209:etiology*; D005076:Exanthema / Q000139:chemically induced*; D006801:Humans; D008297:Male; D010630:Phenindione / Q000009:adverse effects* / Q000031:analogs & derivatives*; D017444:Skin Diseases, Papulosquamous / Q000139:chemically induced*
D010630:Phenindione; C017673:fluindione