ISSN 2564-7784 | E-ISSN 2564-7040
Case Report
How should Helicobacter pylori eradication be done in the extensive proton pump inhibitor allergy?
1 Mersin City Hospital, Pediatric Gastroenterology, Mersin, Turkey  
2 Mersin City Hospital, Pediatric Allergy, Mersin, Turkey  
Eur J Ther ; : -
DOI: 10.5152/EurJTher.2018.654
Key Words: Eradication, extensive proton pump allergy, helicobacter pylori

In this presentation, we would like to discuss the path followed with pediatric allergy in the selection of drug in a case of extensive allergy to (proton pump inhibitor) PPI. A 15-year-old male patient presented with complaints of dyspepsia and epigastric pain for 4-5 years. It was learned that there were fixed drug eruption described with omeprazole and widespread rashes after lansoprazole. Famotidine was started, but the patient was unable to use the drug because of rash and itching in his body 1 hour after drug intake. On physical examination, fixed drug eruption was observed in the whole body and his gluteal region. Gastroduodenoscopy was performed. Macroscopically, the corpus and antrum were hyperemic and antrum nodular, bulbus normal, and duodenum nodular. Multiple biopsies were taken. He was consulted to pediatric allergy department for possible cross-reactions between PPIs. The patient underwent skin prick and intradermal tests with famotidine and ranitidine. The patient also underwent skin patch tests with all available PPIs.  The pathologic result of biopsies was HP (+++) with Giemsa staining. Because of the cross sensitivity between PPIs and the positivity of the allergy tests, triple HP treatment was not considered. This is an interesting case because of the extensive allergies to all existing PPIs and no similar cases have been found in the literature. After evaluation of allergic tests, quadruple treatment without PPI (bismuth, ranitidine, metronidazole and tetracycline) was given to the patient. HP treatment was assessed after 4 weeks, two-step monoclonal stool HP antigen test was found negative.

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AVES | Copyright © 2018 European Journal of Therapeutics | Latest Update: 11.03.2019