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Captopril-induced pemphigus.

1980; BMJ; Volume: 281; Issue: 6234 Linguagem: Inglês

10.1136/bmj.281.6234.194

0959-8138

Patrick S. Parfrey, M Clement, M. J. Vandenburg, P Wright,

Coagulation, Bradykinin, Polyphosphates, and Angioedema

Case reportA 28-year-old European woman presented with nausea and mild diarrhoea.She was taking pyrimethamine 25 mg twice weekly for malaria prophylaxis.A blood film showed malaria parasites.Unfortunately facilities were not available for species identification, but the malaria in the district was generally assumed to be due to Plasmodium falciparum.She was given a course of chloroquine by mouth to a total of 1800 mg.For a body weight of 45 kg that amply met the WHO recommended standards.She had no diarrhoea or vomiting while taking the drug.She had never had malaria before nor had she previously taken chloroquine.The treatment did not relieve her symp- toms-in fact, they were added to by the drug's side effects.Five days after her initial presentation a blood film, examined at a different laboratory, showed abundant parasites.Her haemoglobin concentration was 12 g/dl.She was therefore given Fansidar (pyrimethamine 25 mg, sulphadoxine 500 mg) three tablets immediately.Four days later she again attended, feeling weak and dizzy, with a tempera- ture of 38'C.There were still a few plasmodia in the blood film.She was given chloroquine 800 mg immediately, to be repeated once weekly for three weeks-although only one of these doses was taken.She slowly improved, and two weeks after her first attendance her blood film was clear.No parasites were found in a repeat film after a further two weeks.