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.
Artigo
em Coreano
| 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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Ácido Aminossalicílico
/
Pacientes Desistentes do Tratamento
/
Pirazinamida
/
Tuberculose
/
Metilprednisolona
/
Canamicina
/
Estreptomicina
/
Encefalopatia Hepática
/
Dessensibilização Imunológica
/
Tuberculose Resistente a Múltiplos Medicamentos
Tipo de estudo:
Estudo diagnóstico
/
Guia de Prática Clínica
Limite:
Humanos
/
Masculino
Idioma:
Coreano
Revista:
Allergy, Asthma & Respiratory Disease
Ano de publicação:
2015
Tipo de documento:
Artigo
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