Successful readministration of second-line antituberculous agents in a patient with near-fatal drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome
Allergy, Asthma & Respiratory Disease
;
: 297-301, 2015.
Article
in Korean
| WPRIM
| ID: wpr-83767
ABSTRACT
For the treatment of multidrug-resistant (MDR) tuberculosis, maintenance of appropriate antituberculous agents is essential because of its low cure rate and high dropout rate. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced systemic hypersensitivity response resulting in cessation of causative agents. In cases of second-line antituberculous agent-induced DRESS, it is extremely difficult to find other replacement medications to cure MDR tuberculosis. A 53-year-old male who had taken the second-line antituberculous agents (cycloserine, streptomycin, p-aminosalicylic acid, and prothionamide) as well as pyrazinamide for 5 weeks experienced DRESS syndrome accompanying hepatic coma. His symptoms improved with discontinuation of antituberculous agents and administration of high-dose methylprednisolone for 1 month. To resume the antituberculous medication, second-line antituberculous agents were administered one by one using a rapid desensitization protocol. While kanamycin, levofloxacin, and cycloserine were successfully readministered, p-aminosalicylic acid- and prothionamide-induced cutaneous hypersensitivity symptoms were relatively mild compared to previous reactions. Herein, we report a case of successfully treated MDR tuberculosis having a history of fatal DRESS syndrome to antituberculous agents using the rapid desensitization protocol.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Aminosalicylic Acid
/
Patient Dropouts
/
Pyrazinamide
/
Tuberculosis
/
Methylprednisolone
/
Kanamycin
/
Streptomycin
/
Hepatic Encephalopathy
/
Desensitization, Immunologic
/
Tuberculosis, Multidrug-Resistant
Type of study:
Diagnostic study
/
Practice guideline
Limits:
Humans
/
Male
Language:
Korean
Journal:
Allergy, Asthma & Respiratory Disease
Year:
2015
Type:
Article
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