アブストラクト
Japanese
| Title | Levetiracetamによる新生児薬物離脱症候群 |
|---|---|
| Subtitle | 症例報告 |
| Authors | 柴田有里1,2, 吉田真1, 武内俊樹2, 高橋孝雄2 |
| Authors (kana) | |
| Organization | 1佐野厚生総合病院小児科, 2慶應義塾大学医学部小児学教室 |
| Journal | 脳と発達 |
| Volume | 55 |
| Number | 1 |
| Page | 43-47 |
| Year/Month | 2023 / 1 |
| Article | 報告 |
| Publisher | 日本小児神経学会 |
| Abstract | 「要旨」Levetiracetam(LEV)は催奇形性や遺伝子変異原性が比較的少ないとされ, 挙児希望のあるてんかん女性でしばしば第一選択薬となる. LEVの高い母乳移行率については広く知られているが, 新生児薬物離脱症候群(Neonatal abstinence syndrome; NAS)のリスクに関しては, 未だ不明な点が多い. 我々は, LEV内服母体から出生し, NASを呈したと考えられる新生児を2例経験した. 2例とも妊娠中の胎児発育や心拍モニタリングでは異常を認めず, 仮死はなかった. しかし, 生後1時間以降, NASスコアはそれぞれ最高4点(傾眠, 多呼吸, 哺乳力低下), 8点(傾眠, 筋緊張低下, 無呼吸発作, 多呼吸)を示し, 気管挿管を含む集中管理を要した. 比較的安全とされる薬剤についても, 妊娠中の胎児への薬物移行は避けられず, 新生児の管理には慎重を期す必要がある. 妊娠経過や仮死の有無に関わらず, 薬剤内服母体から出生した児ではNAS発症のリスクを考慮し, 十分な蘇生準備と哺乳が安定するまでの適切な管理が重要である. |
| Practice | 臨床医学：内科系 |
| Keywords | 抗てんかん薬, levetiracetam, 新生児薬物離脱症候群, 薬物離脱, antiepileptic drugs, neonatal abstinence syndrome, withdrawal |
English
| Title | Neonatal abstinence syndrome due to prenatal levetiracetam exposure |
|---|---|
| Subtitle | Case Report |
| Authors | Yuri Shibata1,2, Makoto Yoshida1, Toshiki Takenouchi2, Takao Takahashi2 |
| Authors (kana) | |
| Organization | 1Division of Pediatrics, Sano Kosei general Hospital, 2Department of Pediatrics, Keio University School of Medicine |
| Journal | NO TO HATTATSU (Official Journal of The Japanese Society of Child Neurology) |
| Volume | 55 |
| Number | 1 |
| Page | 43-47 |
| Year/Month | 2023 / 1 |
| Article | Report |
| Publisher | The Japanese Society of Child Neurology |
| Abstract | [Abstract] Levetiracetam (LEV) is one of the least teratogenic anticonvulsants with comparatively low mutagenicity and is thus often the first-choice drug for women of childbearing age with epilepsy. While the high breast milk transfer rate of LEV is widely known, much remains unknown about its role as a potential risk factor for neonatal abstinence syndrome (NAS). We experienced two cases in which neonates presenting with NAS were born to mothers receiving LEV treatment. In both cases, no abnormalities in fetal development or pulse monitoring were observed during gestation, and asphyxia did not occur. However, from 1 hour post-birth onward, the two neonates presented with maximum NAS scores of 4 points (lethargy, tachypnea, and poor feeding) and 8 points (lethargy, hypotonia, apnea, and tachypnea), necessitating intensive care, including tracheal intubation. Drug transfer to the fetus during pregnancy is unavoidable even for drugs that are believed to be relatively safe, hence neonates must be monitored carefully. Regardless of the stability of the pregnancy course or the absence of asphyxia, physicians must be aware of the possibility of NAS onset in infants born to mothers taking certain medications. Sufficient preparation for resuscitation and proper management until the stabilization of feeding behavior are necessary. |
| Practice | Clinical internal medicine |
| Keywords | antiepileptic drugs, levetiracetam, neonatal abstinence syndrome, withdrawal |
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参考文献
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残りの10件を表示する
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