Abstract
BackgroundIcodextrin is a starch-derived, water soluble glucose polymer, which is used as an alternative to glucose in order to enhance dialytic fluid removal in peritoneal dialysis patients. Although the safety and efficacy of icodextrin is well-established, its use in everyday clinical practice has been associated with the appearance of skin rashes and other related skin reactions.Case presentationHerein, we report the rare case of a 91-year-old woman with a history of severe congestive heart failure, who initiated continuous ambulatory peritoneal dialysis with icodextrin-based dialysate solutions and 15 days after the initial exposure to icodextrin developed a generalized maculopapular and exfoliative skin rash extending over the back, torso and extremities. Discontinuation of icodextrin and oral therapy with low-dose methyl-prednisolone with quick dose tapering improved the skin lesions within the following days.ConclusionsThis case report highlights that skin hypersensitivity is a rare icodextrin-related adverse event that should be suspected in patients manifesting skin reactions typically within a few days or weeks after the initial exposure.
Highlights
Icodextrin is a starch-derived, water soluble glucose polymer, which is used as an alternative to glucose in order to enhance dialytic fluid removal in peritoneal dialysis patients
Case presentation We report the case of a 91-year-old woman, who developed a generalized maculopapular, exfoliative skin eruption extending to the back, torso and extremities 15 days after initiation of continuous ambulatory peritoneal dialysis (CAPD) with the use of icodextrin dialysate solutions
The medical history of the patient included stage IV congestive heart failure according to the New York Heart Association (NYHA) classification secondary to massive tricuspid valve failure and severe mitral valve deficiency, chronic atrial fibrillation and stage 4 chronic kidney disease (CKD) with an estimated-glomerular-filtration-rate of 20 ml/min/1.73m2
Summary
Icodextrin is a starch-derived, water soluble glucose polymer, which is used as an alternative to glucose in order to enhance dialytic fluid removal in peritoneal dialysis patients. Conclusions: This case report highlights that skin hypersensitivity is a rare icodextrin-related adverse event that should be suspected in patients manifesting skin reactions typically within a few days or weeks after the initial exposure. Key-words: Icodextrin, Hypersensitivity, Peritoneal dialysis, Skin rash
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