Hypersensitivity to repaglinide

Meglitinides (repaglinide and nateglinide) are insulin secretagogues used to treat diabetes mellitus. we present a case of hypersensitivity reaction to repaglinide in a 61-year-old man who developed a maculopapular rash 5 days after treatment. skin prick tests including repaglinide (0.5 μg/ml) and patch tests (0.05% in pet and saline) were performed,and the results were negative. a blind oral challenge test with repaglinide was performed and the therapeutic dose was subsequently taken at home every 24 hours for 7 days. the result was positive with a delayed reaction at day 3. a punch biopsy of the skin lesions revealed drug-induced exanthema. the clinical manifestations,the latency period,the reappearance of cutaneous lesions after rechallenge,and the histopathology report of the skin biopsy suggest a type iv mechanism. © 2011 esmon publicidad.