Possible Oseltamivir-Induced Angioedema in a Patient with Chronic Renal Failure

Abstract

Objective To report a case of angioedema possibly associated with oseltamivir administration in a patient with chronic renal failure. Case Summary A 46-year-old female with an extensive allergy history and multiple co-morbidities, including chronic renal failure, was diagnosed with H1N1 influenza and given prescriptions for oseltamivir and methylprednisolone at an outside emergency department. She was sent home and took the first dose of both medications. The following day, the patient developed tongue swelling and left-sided edema. She discontinued methylprednisolone but continued oseltamivir. Her symptoms continued to worsen with the development of hivelike lesions and significant shortness of breath leading to hospitalization. Upon admission, oseltamivir was discontinued and the patient was started on dialysis. The patient's symptoms gradually improved, and she was discharged on hospital day 8. Discussion Oseltamivir was thought to be the causative agent due to the abrupt onset and resolution of symptoms associated with the administration and discontinuation of the medication. Application of the Naranjo probability scale found that oseltamivir was a possible cause of the patient's angioedema. Conclusion Health care providers should be aware of the rare but potentially life-threatening angioedema that may be associated with oseltamivir use.