- 期刊
抗結核藥物造成藥物疹合併嗜伊紅血症及全身症狀案例報告
Antituberculosis Drug-Induced Drug Reaction With Eosinophilia and Systemic Symptoms: A Case Report
摘要
抗結核藥物造成的藥物疹合併嗜伊紅血症(drug rash with eosinophilia and systemic symptoms, DRESS)並不常見，常延遲診斷。事實上，此類藥物眾所周知的不良反應為肝毒性及皮膚紅疹，但少見DRESS 案例。本文探討一位55歲女性，診斷為結核病，服用(rifampin 150 mg + isoniazid 75 mg + ethambutol 275 mg + pyrazinamide 400 mg)每日1次，約1個多月後，臉、胸、四肢出現紅疹及脫屑，全身紅腫至急診就醫，並會診皮膚科醫師，診斷為DRESS，轉住院期間給與注射類固醇及症狀治療，10天後狀況穩定改門診追蹤。提醒臨床醫療照護人員應注意此嚴重皮膚藥物不良反應，如果病人出現包括嚴重皮疹、發燒的徵兆或症狀，需立即停藥並就醫診治。
並列摘要
Antituberculosis drugs could cause hepatic and skin events independently, but drug reaction with eosinophilia and systemic symptoms (DRESS) caused by anti-tuberculosis (anti-TB) drugs are rarely reported. We report a case of 60-year-old woman who received (rifampin 150 mg + isoniazid 75 mg + ethambutol 275 mg + pyrazinamide 400 mg) for the treatment of tuberculosis. One month later, she developed skin eruptions with generalized edema over the face, trunk, and limbs. After admission, systemic methylprednisolone was administered and further desquamation was noted. The laboratory examination showed leukocytosis with eosinophilia. Clinicians involved in the care of such patients need to be aware of the characteristic skin reactions (e.g., facial edema, generalized infiltrative rashes, desquamation), fever, and internal organ involvements, and the suspected culprit drugs should be discontinued immediately.