Connection between dermatomyositis and montelukast sodium use: A case report

BACKGROUND

Montelukast or Singulair is a leukotriene receptor antagonist that reduces inflammation and relaxes the smooth muscles. It is known to be a safe and tolerable drug; nevertheless, it might be associated with several mild to severe adverse effects, one of which is dermatomyositis. Dermatomyositis is a rare acquired autoimmune myositis of unknown cause affecting adults and children. The literature has infrequently reported the association between dermatomyositis and montelukast use.

CASE SUMMARY

The current study reports a case of a 48-year-old black woman with a previous history of bronchial asthma and allergic rhinosinusitis who presented with typical signs and symptoms of dermatomyositis which were confirmed by investigations. Before developing dermatomyositis, the patient was prescribed montelukast for atopy and consumed the drug for five months. After administration of prednisolone, the patient had a significant improvement and is still being followed up.

CONCLUSION

Even though montelukast is widely used and believed to be a safe drug for managing several conditions, the present case report highlights the possibility of adverse effects of montelukast. Therefore, future studies with advanced study designs are highly recommended to investigate the association between dermatomyositis and montelukast use.

Exercise-induced asthma: critical analysis of the protective role of montelukast

Exercise-induced asthma/exercise-induced bronchospasm (EIA/EIB) is a prevalent and clinically important disease affecting young children through older adulthood. These terms are often used interchangeably and the differences are not clearly defined in the literature. The pathogenesis of EIA/EIB may be different in those with persistent asthma compared to those with exercise-induced symptoms only. The natural history of EIA is unclear and may be different for elite athletes. Leukotriene biology has helped the understanding of EIB. The type and intensity of exercise are important factors for EIB. Exercise participation is necessary for proper development and control of EIA is recommended. Symptoms of EIB should be confirmed by proper testing. Biologic markers may also be helpful in diagnosis. Not all exercise symptoms are from EIB. Many medication and nonpharmacologic treatments are available. Asthma education is an important component of managing EIA. Many medications have been tested and the comparisons are complicated. Montelukast is a US Food and Drug Administration-approved asthma and EIB controller and has a number of potential advantages to other asthma medications including short onset of action, ease of use, and lack of tolerance. Not all patients improve with montelukast and rescue medication should be available.