Article: A granulomatous drug eruption induced by entecavir

Entecavir (Baraclude®, Bristol-Myers Squibb) is a potent and selective antiviral agent that has demonstrated efficacy in patients with chronic hepatitis B. The most frequent adverse events attributed to entecavir include increased alanine aminotransferase, upper respiratory tract infection, headache, abdominal pain, cough, pyrexia, fatigue, and diarrhea. Although quite a few randomized double-blind studies including ones investigating adverse events along with these general symptoms have been reported, few cases of cutaneous adverse events have been described in detail. We demonstrate a case of granulomatous drug eruption as a cutaneous adverse event induced by entecavir.

Citing Articles

"Black box warning" rash with entecavir - case report.

Cheong X, Wong Z, Md Nor N, Lee B BMC Gastroenterol. 2020; 20(1):305.

PMID: 32948126 PMC: 7501723. DOI: 10.1186/s12876-020-01452-3.

A case of entecavir-associated bullous fixed drug eruption and a review of literature.

Temiz S, Ozer I, Ataseven A, Findik S Turk J Gastroenterol. 2018; 30(3):299-302.

PMID: 30459136 PMC: 6428509. DOI: 10.5152/tjg.2018.17887.

References

1.

Kobashi H, Takaguchi K, Ikeda H, Yokosuka O, Moriyama M, Imazeki F . Efficacy and safety of entecavir in nucleoside-naive, chronic hepatitis B patients: phase II clinical study in Japan. J Gastroenterol Hepatol. 2009; 24(2):255-61. DOI: 10.1111/j.1440-1746.2008.05593.x. View

2.

Chang T, Gish R, Hadziyannis S, Cianciara J, Rizzetto M, Schiff E . A dose-ranging study of the efficacy and tolerability of entecavir in Lamivudine-refractory chronic hepatitis B patients. Gastroenterology. 2005; 129(4):1198-209. DOI: 10.1053/j.gastro.2005.06.055. View

3.

Chang T, Gish R, de Man R, Gadano A, Sollano J, Chao Y . A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. N Engl J Med. 2006; 354(10):1001-10. DOI: 10.1056/NEJMoa051285. View

4.

Ono S, Kato N, Shiratori Y, Kato J, Goto T, Schinazi R . The polymerase L528M mutation cooperates with nucleotide binding-site mutations, increasing hepatitis B virus replication and drug resistance. J Clin Invest. 2001; 107(4):449-55. PMC: 199250. DOI: 10.1172/JCI11100. View

5.

Magro C, Crowson A, Schapiro B . The interstitial granulomatous drug reaction: a distinctive clinical and pathological entity. J Cutan Pathol. 1998; 25(2):72-8. DOI: 10.1111/j.1600-0560.1998.tb01693.x. View

6.

Lai C, Rosmawati M, Lao J, Van Vlierberghe H, Anderson F, Thomas N . Entecavir is superior to lamivudine in reducing hepatitis B virus DNA in patients with chronic hepatitis B infection. Gastroenterology. 2002; 123(6):1831-8. DOI: 10.1053/gast.2002.37058. View

7.

Horn T, Burke P, Karp J, Hood A . Intravenous administration of recombinant human granulocyte-macrophage colony-stimulating factor causes a cutaneous eruption. Arch Dermatol. 1991; 127(1):49-52. View

8.

Fujita Y, Shimizu T, Shimizu H . A case of interstitial granulomatous drug reaction due to sennoside. Br J Dermatol. 2004; 150(5):1035-7. DOI: 10.1111/j.1365-2133.2004.05916.x. View

9.

Sugiura K, Sugiura M, Takashi T, Naoki H, Itoh A . Immediate allergy, drug-induced eruption, by entecavir. J Eur Acad Dermatol Venereol. 2008; 23(4):487-9. DOI: 10.1111/j.1468-3083.2008.02932.x. View

10.

Lee M, Choi J, Sung K, Moon K, Koh J . Interstitial and granulomatous drug reaction presenting as erythema nodosum-like lesions. Acta Derm Venereol. 2003; 82(6):473-4. DOI: 10.1080/000155502762064692. View

11.

de Man R, Wolters L, Nevens F, Chua D, Sherman M, Lai C . Safety and efficacy of oral entecavir given for 28 days in patients with chronic hepatitis B virus infection. Hepatology. 2001; 34(3):578-82. DOI: 10.1053/jhep.2001.26815. View

A Granulomatous Drug Eruption Induced by Entecavir