DPP4 Inhibitor-Induced Bullous Pemphigoid in Patients with Diabetes and Chronic Kidney Disease: Clinical Case Series

Clinical Practice: Case Report

Charitaki E.a· Damianakis N.a· Garbidaki A.b· Stamataki E.a· Liapis K.c· Papadaki A.a· Tzanakis I.a

Author affiliations

aDepartment of Nephrology, General Hospital of Chania “A. Georgios,”, Chania, Greece
bDepartment of Dermatology, General Hospital of Chania “A. Georgios,”, Chania, Greece
cDemocritus University of Thrace Medical School, Alexandroupolis, Greece

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Article / Publication Details

First-Page Preview

Abstract of Clinical Practice: Case Report

Received: April 01, 2022
Accepted: June 01, 2022
Published online: July 18, 2022

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 1

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF

Abstract

Introduction: Dipeptidyl peptidase-4 (DPP4) inhibitors (gliptins) are commonly prescribed for glucose control in patients with advanced chronic kidney disease (CKD) in whom other oral glucose-lowering agents are contraindicated. In the past few years, new reports of drug-induced bullous pemphigoid associated with DPP4 inhibitors have emerged. However, there is not enough information about the renal function of the patients with DPP4 inhibitor-induced bullous pemphigoid, and it remains unknown whether the risk of this complication is increased among patients with CKD. Case Reports: Five patients with stage 3b-5 CKD received a diagnosis of DPP4 inhibitor-associated bullous pemphigoid in our institution within a period of 17 months (between December 2018 and May 2020). All patients in the current series were male. Skin biopsies were performed in all patients. Three cases were secondary to vildagliptin, and 2 cases were attributed to linagliptin. In each of these patients, treatment consisted of permanent discontinuation of the DPP4 inhibitor and administration of corticosteroids. Conclusion: We report here the first single-center experience of DPP4 inhibitor-induced bullous pemphigoid in patients with CKD. Our case series highlights the importance of considering bullous pemphigoid in patients with CKD taking DPP4 inhibitors presenting with bullous or pruritic cutaneous lesions. By calling attention to this important complication, we hope to minimize the delay in diagnosing DPP4 inhibitor-induced bullous pemphigoid among patients with CKD.

© 2022 S. Karger AG, Basel

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First-Page Preview

Abstract of Clinical Practice: Case Report

Received: April 01, 2022
Accepted: June 01, 2022
Published online: July 18, 2022

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 1

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF

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