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논문 기본 정보

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학술저널
저자정보
Jin Hyun Jung (Department of Internal Medicine Medical School of Yeungnam University Daegu Korea.) Kang Dong Yoon (Drug Safety Monitoring Center Seoul National University Hospital Seoul Korea.) 남영희 (Department of Internal Medicine College of Medicine Dong-A University Busan Korea.) 예영민 (Department of Allergy and Clinical Immunology Ajou University School of Medicine Suwon Korea.) Koh Young-Il (Department of Internal Medicine Chonnam National University Hospital Gwangju Korea.) 허규영 (Department of Internal Medicine Korea University College of Medicine Seoul Korea.) Kim Sae-Hoon (Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.) Yang Min-Suk (Department of Internal Medicine SMG-SNU Boramae Medical Center Seoul Korea.) 김수정 (Department of Internal Medicine School of Medicine Kyungpook National University Daegu Korea.) Jeong Yi Yeong (Department of Internal Medicine Gyeongsang National University College of Medicine Gyeongsang Natio) 김민혜 (Department of Internal Medicine College of Medicine Ewha Womans University Seoul Korea.) Choi Jeong Hee (Department of Pulmonology and Allergy Hallym University Dongtan Sacred Heart Hospital Hwaseong and) 강혜련 (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Jo Eun-Jung (Department of Internal Medicine Pusan National University College of Medicine Busan Korea.) Park Hye-Kyung (Department of Internal Medicine Pusan National University College of Medicine Busan Korea.)
저널정보
대한천식알레르기학회(구 대한알레르기학회) Allergy, Asthma & Immunology Research Allergy, Asthma & Immunology Research Vol.13 No.2
발행연도
2021.1
수록면
245 - 255 (11page)

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Purpose: Anti-tuberculosis drugs (ATDs) can cause severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Underlying tuberculous infection and co-administration of multiple drugs may contribute to the complexity of ATD-related SCARs. This study aimed to investigate the clinical characteristics and outcomes of ATD-related SCARs. Methods: We analyzed ATD-related SCAR cases in 2010-2015, selected from a web-based Database of the Korean Registry of SCAR. Results: Among 783, 53 patients with ATD-induced SCARs were enrolled, including 12 with SJS/TEN (22.6%) and 41 with DRESS (77.4%). When comparing the ATD and non-ATD groups, the prevalence of DRESS patients was higher in the ATD group than in the non-ATD group (77.4% vs. 45.8%, P < 0.001). Among patients with ATD-related SCARs, those with SJS/TEN were significantly older, had higher intensive care unit admissions, and had higher mortality than those with DRESS (70.5 vs. 50.0 years, P < 0.001; 41.7% vs. 6.1%, P = 0.010; and 33.3% vs. 2.5%, P = 0.003, respectively). ATDs were challenged in 14 cases. The ATD associated most often with SCAR cases was rifampin (81.8%), followed by isoniazid (66.7%), ethambutol (50.0%), pyrazinamide (33.3%). Six patients (42.9%) had hypersensitivity reactions to 2 or more drugs. Conclusions: DRESS was more common among the ATD-related SCAR cases. Although treatment with most ATDs carries the risk of SCAR development, the use of rifampin was most frequently involved in the occurrence of SCARs. Multiple hypersensitivity was frequently observed in ATD-related SCARs.
#Antitubercular agents #severe cutaneous adverse reactions #Stevens-Johnson syndrome #toxic epidermal necrolysis #drug reaction with eosinophilia and systemic symptoms #drug hypersensitivity syndrome #skin #isoniazid #rifampin

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참고문헌 (34)

참고문헌 신청
World Health Organization / 2016 / Global tuberculosis report google schola Buhari GK / 2015 / Immediate-type hypersensitivity reactions due to antituberculosis drugs : a successful readministration protocol / Ann Allergy Asthma Immunol 115:39~44 google schola Lehloenya RJ / 2012 / Cutaneous adverse drug reactions to anti-tuberculosis drugs : state of the art and into the future / Expert Rev Anti Infect Ther 10:475~486 google schola Chung WH / 2016 / Severe cutaneous adverse drug reactions / J Dermatol 43:758~766 google schola Allouchery M / 2018 / Antituberculosis drug-associated DRESS : a case series / J Allergy Clin Immunol Pract 6:1373~1380 google schola

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