Montelukast is a leukotriene receptor antagonist that is effective in the treatment of allergic rhinitis and asthma. We report a rare case of a 31-year-old woman with a history of allergic rhinitis and moderate persistent asthma, who experienced severe bruising on her lower extremities after starting montelukast treatment. Clinicians should be aware of the possibility of unusual bruising during montelukast therapy, and in those patients montelukast should be discontinued.
MasoliM, FabianD, HoltS, BeasleyR; on behalf of the Global Initiative for Asthma (GINA) Program. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy, 2004; 59(5):469-478.
2.
MarpleBF, FornadleyJA, PatelAA, FinemanSM, FromerL, KrouseJH, et al. Keys to successful management of patients with allergic rhinitis: focus on patient confidence, compliance, and satisfaction. Otolaryngol Head Neck Surg, 2007; 136(6):107-124.
3.
TripathiA, PattersonR. Impact of allergic rhinitis treatment on quality of life. Pharmacoeconomics, 2001; 19(9):891-899.
4.
GuerraS, SherrillDL, MartinezFD, BarbeeRA. Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol, 2002; 109(3):419-425.
5.
LeynaertB, NeukirchF, DemolyP, BousquetJ. Epidemiologic evidence for asthma and rhinitis comorbidity. J Allergy Clin Immunol, 2000; 106(5):201-205.
6.
NayakA, LangdonR. Montelukast in the treatment of allergic rhinitis: an evidence-based review. Drugs, 2007; 67(6):887-901.
7.
LagosJA, MarshallGD. Montelukast in the management of allergic rhinitis. Ther Clin Risk Manag, 2007; 3(2):327-332.
8.
DempseyOJ. Leukotriene receptor antagonist therapy. Postgrad Med J, 2000; 76(902):767-773.
9.
JamaliAN, AqilM, AlamMS, PillaiKK, KapurP. A pharmacovigilance study on patients of bronchial asthma in a teaching hospital. J Pharm Bioallied Sci, 2010; 2(4):333-336.
10.
MalmstromK, Rodriguez-GomezG, GuerraJ, VillaranC, PiñeiroA, WeiLX, et al; Montelukast/Beclomethasone Study Group. Oral montelukast, inhaled beclomethasone, and placebo for chronic asthma: a randomized, controlled trial. Ann Intern Med, 1999; 130(6):487-495.
11.
MeltzerEO, LockeyRF, FriedmanBF, KalbergC, Goode-SellersS, SrebroS, et al. Efficacy and safety of low-dose fluticasone propionate compared with montelukast for maintenance treatment of persistent asthma. Mayo Clin Proc, 2002; 77(5):437-445.
12.
Romero-GómezM, Sánchez-MuñozD, CastillaL, CastroM. [Acute hepatitis due to montelukast]. Med Clin (Barc), 2003; 120(6):239. Article in Spanish.
SassDA, ChopraKB, WuT. A case of montelukast-induced hepatotoxicity. Am J Gastroenterol, 2003; 98(3):704-705.
15.
LittJZ. Litt's drug eruption reference manual: including drug interactions, 11th edition. London: Informa; 2011:452.
16.
UK Medicines and Healthcare Products Regulatory Agency and Committee on Safety of Medicines. Leukotriene receptor antagonists: update on adverse reaction profiles. Curr Probl Pharmacovigilance, 1999; 25:14.
17.
DuMouchelW, SmithET, BeasleyR, NelsonH, YangX, FramD, et al. Association of asthma therapy and Churg-Strauss syndrome: an analysis of postmarketing surveillance data. Clin Ther, 2004; 26(7):1092-1104.
18.
WechslerME, FinnD, GunawardenaD, WestlakeR, BarkerA, HaranathSP, et al. Churg-Strauss syndrome in patients receiving montelukast as treatment for asthma. Chest, 2000; 117(3):708-713.
19.
DavisMD, DaoudMS, McEvoyMT, SuWP. Cutaneous manifestations of Churg-Strauss syndrome: a clinicopathologic correlation. J Am Acad Dermatol, 1997; 37(2):199-203.
20.
KatzensteinAL. Diagnostic features and differential diagnosis of Churg-Strauss syndrome in the lung. A review. Am J Clin Pathol, 2000; 114(5):767-772.
21.
WechslerME, GarpestadE, FlierSR, KocherO, WeilandDA, PolitoAJ, et al. Pulmonary infiltrates, eosinophilia, and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast. JAMA, 1998; 279(6):455-457.
MasiAT, HunderGG, LieIT, MichelBA, BlochDA, ArendWP, et al. The American College of Rheumatology 1990 criteria for the classification of the Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum, 1990; 33(8):1094-1100.
24.
NaranjoCA, BustoU, SellersEM, SandorP, RuizI, RobertsEA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther, 1981; 30(2):239-245.
