ANGIOEDEMA AND URTICARIA ASSOCIATED WITH OMEPRAZOLE CONFIRMED BY DRUGRECHALLENGE

Omeprazole is a substituted benzimidazole that has gained widespread u se in the treatment of acidic and peptic ulcer disease. Adverse events with the drug are rare and involve mainly the gastrointestinal and ce ntral nervous systems. Skin inflammation, urticaria, pruritus, alopeci a, and dry skin have been reported in 0.5-1.5% of patients. To date, n o published report has linked angioedema with omeprazole. We report a case of a 34-year-old woman with cellulitis, ulcerative erosive esopha gitis, and gastric and duodenal ulcers who developed several hypersens itivity reactions characterized by shortness of breath, wheezing, coug h, mild angioedema, and total body urticaria and pruritus. These sympt oms correlated with the addition of omeprazole to her regimen and the timing of its administration. A previous case report prompted a rechal lenge with enteric-coated omeprazole granules removed from the capsule shell. Recurrence of the adverse events suggested an allergy to the d rug itself and not the capsule. Angioedema can be a life-threatening a llergic reaction requiring immediate treatment. Rechallenge using omep razole with or without the capsule shell should be done only in a hosp ital setting where prompt action can be taken in the event of an emerg ency.