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Fatal Hypersensitivity Reactions Induced by Re-Administration of Rifampin in an Immunocompetent Patient with Tuberculous Lymphadenopathy

결핵성 임파선염 환자에서 Rifampin 재투여로 인한 치명적 과민성 반응 1예

  • Kim, Ye-Ji (Division of Infections Diseases, Department of Internal Medicine, Korea University College of Medicine) ;
  • Yim, Sun-Young (Division of Infections Diseases, Department of Internal Medicine, Korea University College of Medicine) ;
  • Bae, Song-I (Division of Infections Diseases, Department of Internal Medicine, Korea University College of Medicine) ;
  • Ahn, Jae-Hee (Division of Infections Diseases, Department of Internal Medicine, Korea University College of Medicine) ;
  • Chang, Won-Gin (Division of Infections Diseases, Department of Internal Medicine, Korea University College of Medicine) ;
  • Sohn, Jang-Wook (Division of Infections Diseases, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Min-Ja (Division of Infections Diseases, Department of Internal Medicine, Korea University College of Medicine)
  • 김예지 (고려대학교 의과대학 감염내과) ;
  • 임선영 (고려대학교 의과대학 감염내과) ;
  • 배송이 (고려대학교 의과대학 감염내과) ;
  • 안재희 (고려대학교 의과대학 감염내과) ;
  • 장원진 (고려대학교 의과대학 감염내과) ;
  • 손장욱 (고려대학교 의과대학 감염내과) ;
  • 김민자 (고려대학교 의과대학 감염내과)
  • Published : 2012.01.01

Abstract

A 44-year-old patient who had been diagnosed with tuberculous lymphadenopathy came to our hospital with a rash. He began to take antituberculous medications, but the next day, a rash appeared and persisted for one week. When he came to the hospital, he had already stopped the medication by his own decision. We stopped all drugs and reintroduced one drug at a time. After re-administration of rifampin, anaphylactic shock and subsequent acute renal failure and rhabdomyolysis occurred. Intensive care was performed, but the patient died 60 h after the first hypersensitive reaction that occurred due to rifampin. Anaphylaxis and subsequent rhabdomyolysis induced by rifampin is an extremely rare event. It is necessary to initially prescribe low dose rifampin in cases of re-administration.

저자들은 rifampin에 과민 반응이 있는 환자가 rifampin에 다시 노출된 후, 아나필락시스 및 횡문근 융해증, 급성 신부전, 파종성 혈관내응고증후군이 병별하여 결국 사망에 이르렀던 예를 경험하여 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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