アブストラクト
Japanese
| Title | 原因として感冒薬が疑われたStevens-Johnson syndromeの1例 |
|---|---|
| Subtitle | 症例報告 |
| Authors | 竹内陽平1), 小林貴江2), 河邊太加志2) |
| Authors (kana) | |
| Organization | 1)大垣市民病院第2小児科, 2)春日井市民病院小児科 |
| Journal | アレルギー |
| Volume | 71 |
| Number | 4 |
| Page | 328-333 |
| Year/Month | 2022 / |
| Article | 報告 |
| Publisher | 日本アレルギー学会 |
| Abstract | 今回, チペピジンヒベンズ酸塩 (アスベリン(R)散) が原因として疑われたスティーブンス・ジョンソン症候群 (Stevens-Johnson syndrome : SJS) を経験した. 症例は7歳男児. チペピジンヒベンズ酸塩 (アスベリン(R)散) , L-カルボシステイン (カルボシステイン(R)DS) 内服翌日に, 38℃以上の発熱, 喘鳴, 酸素飽和度の低下, 2日後に口唇・眼粘膜・外陰部の糜爛などの粘膜疹, 体幹部の水疱が生じSJSと診断した. 眼には偽膜形成, 角膜上皮欠損も認めたため, 発症早期にステロイドパルス療法を施行し回復した. 発症から3年経過したが明らかな後遺症は認めていない. 原因検索として施行した薬剤リンパ球刺激試験 (drug induced lymphocyte stimulation test : DLST) で, チペピジンヒベンズ酸塩+L-カルボシステイン合剤, チペピジンヒベンズ酸塩が陽性を示した. 文献では, チペピジンヒベンズ酸塩でのSJS報告例は無かった. チペピジンヒベンズ酸塩は広く小児医療において使用されている代表的な薬剤であるが, SJSの原因になりうるので, 投与に際しては十分に注意が必要である. |
| Practice | 臨床医学：内科系 |
| Keywords | drug induced lymphocyte stimulation test : DLST, human leukocyte antigen : HLA, L-carbocysteine, Stevens-Johnson syndrome : SJS, tipepidine hibenzate |
English
| Title | A CASE OF STEVENS-JOHNSON SYNDROME SUSPECTED BY A COMMON COLD MEDICATION AS CAUSE |
|---|---|
| Subtitle | |
| Authors | Yohei Takeuchi1), Takae Kobayashi2), Takashi Kawabe2) |
| Authors (kana) | |
| Organization | 1)Department of Pediatrics II, Ogaki Municipal Hospital, 2)Department of Pediatrics, Kasugai Municipal Hospital |
| Journal | Japanese Journal of Allergology |
| Volume | 71 |
| Number | 4 |
| Page | 328-333 |
| Year/Month | 2022 / |
| Article | Report |
| Publisher | JAPANESE SOCIETY OF ALLERGOLOGY |
| Abstract | We describe here the case of a 7-year-old male patient with Stevens-Johnson syndrome (SJS), which was suspected to be caused by treatment with tipepidine hibenzate (Asverin(R)). The day after taking tipepidine hibenzate and L-carbocysteine (Carbocysteine(R) DS) for relief of a cold, he began presenting with the following symptoms : fever above 38℃, wheezing, and decreased oxygen saturation. Two days later, mucous membrane rashes, such as erosions on the lips, eye mucosa, vulva, and blisters on the trunk appeared, and SJS was thus diagnosed. Because pseudomembrane formation and corneal epithelial defect in the eyes were also observed, steroid pulse therapy was administered early in the course of the disease, and the patient recovered without sequelae. A drug-induced lymphocyte stimulation test performed to determine the cause of the disease was positive for fixed-dose combination therapy with tipepidine hibenzate plus L-carbocysteine and for tipepidine hibenzate alone. It has now been three years since the onset of the disease, and no sequelae have been observed. Although tipepidine hibenzate is a drug frequently used for pediatric patients, it should be administered with caution because of its potential to cause SJS. |
| Practice | Clinical internal medicine |
| Keywords | drug induced lymphocyte stimulation test : DLST, human leukocyte antigen : HLA, L-carbocysteine, Stevens-Johnson syndrome : SJS, tipepidine hibenzate |
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参考文献
- 1) 塩原哲夫, 狩野葉子, 水川良子, 佐山浩二, 橋本公二, 藤山幹子, 他. 重症多形滲出性紅斑スティーヴンス・ジョンソン症候群・中毒性表皮壊死症診療ガイドライン. 日皮会誌 2016;126:1637-85.
- 2) Hirakawa S, Ohtsu T, Ojima Y, Kouchi H, Uchida S, Kanzaki H, et al. Acute myocardial infraction following toxic epidermal necrolysis? Clin Exp Dermatol 1999;24:375-8.
- 3) Borrelli EP, Lee EY, Descoteaux AM, Kogut SJ, Caffrey AR. Stevens-Johnson syndrome and toxic epidermal necrolysis with antiepileptic drugs:An analysis of the US Food and Drug Administration Adverse Event Reporting System. Epilepsia 2018;59:2318-24.
- 4) Inada A, Oyama S, Niinomi I, Wakabayashi T, Iwanaga K, Hosohata K. Association of Stevens-Johnson syndrome and toxic epidermal necroly-sis with antiepileptic drugs in pediatric patients:Subgroup analysis based on a Japanese spontane-ous database. J Clin Pharm Ther 2019;44:775-9.
- 5) Olson D, Watkins L, Francois LK, Demirjian A, Lin X, Robinson C, et al. Outbreak of Mycoplasma pneumoniae-associated Stevens-Johnson Syn-drome. PEDIATRICS 2015;136:386-94.
残りの2件を表示する
- 6) Ueta M, Kaniwa N, Sotozono C, Tokunaga K, Saito Y, Sawai H, et al. Independent strong asso-ciation of HLA-A*02:06 and HLA-B*44:03 with cold medicine-related Stevens-Johnson syndrome with severe mucosal involvement. Scientific Re-ports 2014;4:4862 1-6.
- 7) 斎藤嘉朗, 児玉 進, 杉山永見子, 中村亮介. 重篤副作用に関する予測ゲノムマーカー, 薬学雑誌 2015;135:589-95.
