Xylometazoline abuse

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Hypertensive crisis and end-organ damage: case report A 34-year-old man developed a hypertensive crisis and end-organ damage during long-term abuse of OTC xylometazoline. The man presented with a 2-month history of blurred vision and a frontal headache due to papilloedema and hypertensive retinopathy stage IV. On examination, his BP was 210/120mm Hg. He had used xylometazoline nasal spray every 3 hours [dose not stated] for the past 2 years for nasal congestion. Following admission, he was treated with labetalol and urapidil. Evaluation of end-organ damage revealed concentric left ventricular hypertrophy; his serum creatinine level was elevated and he displayed microalbuminuria. A kidney biopsy was notable for hypertensive nephrosclerosis. Xylometazoline spray was replaced with topical fluticasone propionate. The man was discharged with a BP of 135/75mm Hg, under treatment with amlodipine. During follow-up, his creatinine level remained unchanged at 1.80 mg/dL. Buysschaert I, et al. Hypertensive crisis and end-organ damage induced by overthe-counter nasal decongestant abuse. European Heart Journal 32: 3114, No. 24, 803069006 Dec 2011 - Belgium

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Reactions 7 Apr 2012 No. 1396