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Esomeprazole/omeprazole Respiratory distress and facial oedema in an infant: case report A 4-month-old female infant developed respiratory distress and facial oedema while receiving omeprazole and esomeprazole. The infant, who had undergone surgical repair of a ’longgap’ oesophageal atresia, was referred with anastomotic stricture and severe gastro-oesophageal reflux. She began receiving omeprazole 0.8 mg/kg daily. She developed a progressive tendency towards episodes of respiratory distress with chest retraction, wheezing and tachypnoea, which occurred 30–60 minutes after omeprazole administration. These episodes were sporadically associated with mild facial oedema. She was tentatively diagnosed with an adverse reaction to omeprazole. Omeprazole was withdrawn. The infant’s respiratory disturbances were dramatically relieved. Six months later, her anastomotic stricture was surgically repaired. A few hours later, while on mechanical ventilation, she started to receive esomeprazole at a dosage of 0.8 mg/kg daily. Immediately after esomeprazole administration, she experienced a severe pulmonary deterioration. Withdrawal of ventilatory support was only possible after esomeprazole was discontinued. Baldassarre E, et al. Severe systemic adverse reaction to proton pump inhibitors in an infant. Pediatric Pulmonology 42: 563-564, No. 6, Jun 2007 801094478 Switzerland

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Reactions 11 Aug 2007 No. 1164