Although proton pump inhibitors (PPI) are generally well tolerated, with most adverse effects being minor and self-limiting, there are singular reports on hypersensitivity immune reactions triggered by a PPI or its metabolites. Here we report a case of acute drug-induced fever with leukocytosis and a transient increase in CRP due to pantoprazole. This was apparently an idiosyncratic reaction (inflammatory fever), showing no cross-sensitivity towards esomeprazole.

1.
Shi S, Klotz U: Proton pump inhibitors: an update of their clinical use and pharmacokinetics. Eur J Clin Pharmacol 2008;64:935-951.
2.
Thomson AB, Sauve MD, Kassam N, Kamitakahara H: Safety of the long-term use of proton pump inhibitors. World J Gastroenterol 2010;16:2323-2330.
3.
Mouli VP, Ahuja V: Proton pump inhibitors: concerns over prolonged use. Trop Gastroenterol 2011;32:175-184.
4.
Ra A, Tobe SW: Acute interstitial nephritis due to pantoprazole. Ann Pharmacother 2004;38:41-45.
5.
Brewster UC, Perazella MA: Acute kidney injury following proton pump inhibitor therapy. Kidney Int 2007;71:589-593.
6.
Klassen S, Krepinsky JC, Prebtani AP: Pantoprazole-induced acute interstitial nephritis. CMAJ 2013;185:56-59.
7.
Landray MJ, Ringrose T, Ferner RE, Arnold IR: Pyrexia, anaemia and acute renal failure secondary to omeprazole. Postgrad Med J 1998;74:416-422.
8.
Grattagliano I, Portincasa P, Mastronardi M, Palmieri VO, Palasciano G: Esomeprazole-induced central fever with severe myalgia. Ann Pharmacother 2005;39:757-760.
9.
Cheng FC, Ho YF, Hung LC, Chen CF, Tsai TH: Determination and pharmacokinetic profile of omeprazole in rat blood, brain and bile by microdialysis and high-performance liquid chromatography. J Chromatogr A 2002;949:35-42.
10.
Smyth EM, Grosser T, Wang M, Yu Y, FitzGerald GA: Prostanoids in health and disease. J Lipid Res 2009;50:S423-S428.
11.
Kepil Özdemir S, Yılmaz I, Aydin Ö, Büyüköztürk S, Gelincik A, Demirtürk M, Erdoğdu D, Cömert S, Erdoğan T, Karakaya G, Kalyoncu AF, Oner Erkekol F, Dursun AB, Misirligil Z, Bavbek S: Immediate-type hypersensitivity reactions to proton pump inhibitors: usefulness of skin tests in the diagnosis and assessment of cross-reactivity. Allergy 2013;68:1008-1014.
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