Montelukast-induced generalized urticaria.
OBJECTIVE
To report a case of generalized urticaria induced by montelukast treatment.


METHODS
A 28-year-old man with allergic rhinitis and moderate persistent asthma developed generalized urticaria 5 days after the initiation of montelukast and inhaled fluticasone. Symptoms disappeared within one day after suspension of both drugs. Two months later, after the resumption of montelukast and fluticasone, the patient developed generalized urticaria and eyelid angioedema, which were successfully treated with intravenous betamethasone, achieving complete remission within hours. After 2 days, the patient resumed inhaled fluticasone only and continued this therapy for several months without any adverse reaction.


CONCLUSIONS
We attributed the adverse reaction to montelukast because of the temporal relationship between use of montelukast and urticaria, the absence of other identified causative factors and other explanations for allergic reactions, and the positive dechallenge and rechallenge. The Naranjo probability scale showed a probable relationship between skin manifestations and montelukast treatment.


CONCLUSIONS
The use of antileukotrienes is increasing in asthma therapy. In cases of generalized urticaria in asthmatic patients undergoing montelukast therapy, physicians should be aware of a potential adverse reaction to this drug.
Minciullo
Paola L
PL
Department of Human Pathology, Division and School of Allergy and Clinical Immunology, University of Messina, 98123 Messina, Italy.
Saija
Antonella
A
Bonanno
Domenica
D
Ferlazzo
Edoardo
E
Gangemi
Sebastiano
S
D000085:Acetates / Q000009:adverse effects*; D000328:Adult; D003521:Cyclopropanes; D006801:Humans; D020024:Leukotriene Antagonists / Q000009:adverse effects*; D008297:Male; D011804:Quinolines / Q000009:adverse effects*; D013440:Sulfides; D014581:Urticaria / Q000139:chemically induced*
D000085:Acetates; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C093875:montelukast