The Korean journal of internal medicine

  • 제34권5호
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  • Pages.1050-1057
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  • 2019
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

Cutaneous adverse drug reactions in patients with peripheral blood eosinophilia during antituberculosis treatment

  • Kim, Tae-Ok (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Shin, Hong-Joon (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kim, Yu-Il (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Lim, Sung-Chul (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Koh, Young-Il (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kwon, Yong-Soo (Department of Internal Medicine, Chonnam National University Hospital)
  • 투고 : 2018.02.17
  • 심사 : 2018.07.25
  • 발행 : 2019.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Peripheral eosinophilia during tuberculosis (TB) treatment is common, but has not been fully evaluated. The aim of this study was to determine the prevalence and clinical significance of peripheral blood eosinophilia in patients undergoing anti-TB treatment. Methods: We retrospectively reviewed the clinical and laboratory data of patients who received anti-TB treatment and had peripheral blood eosinophilia (> 5% of the total white blood cell count) at the Chonnam National University Hospital between January 2010 and December 2014. Results: Of all 2,234 patients with TB who received anti-TB treatment, 397 (17.8%) had peripheral blood eosinophilia. Of the 397 with eosinophilia, we reviewed the data of 262 (66%), and cutaneous adverse drug reactions (CADRs) were observed in 161 (61.5%). Of the 161 with CADRs, itching (47.2%) and skin rash (47.8%) were common. Older age, abnormal liver function, and higher peak blood eosinophil percentage were associated with CADRs in multivariate analysis. There was a significant relationship between increased peak eosinophil counts and the degree of severity of CADRs. Conclusions: Peripheral blood eosinophilia is a relatively common occurrence during anti-TB treatment. Peripheral blood eosinophil counts were higher according to the degree of severity of CADRs.

키워드

과제정보

This study was supported by the National Research Foundation of Korea funded by the Korean Government (Grant 2016R1D1A1B03931132).

참고문헌

  1. Rezakovic S, Pastar Z, Kostovic K. Cutaneous adverse drug reactions caused by antituberculosis drugs. Inflamm Allergy Drug Targets 2014;13:241-248. https://doi.org/10.2174/1871528113666140717113358
  2. Lehloenya RJ, Dheda K. Cutaneous adverse drug reactions to anti-tuberculosis drugs: state of the art and into the future. Expert Rev Anti Infect Ther 2012;10:475-486. https://doi.org/10.1586/eri.12.13
  3. Kolappan C, Subramani R, Kumaraswami V, Santha T, Narayanan PR. Excess mortality and risk factors for mortality among a cohort of TB patients from rural south India. Int J Tuberc Lung Dis 2008;12:81-86.
  4. Yee D, Valiquette C, Pelletier M, Parisien I, Rocher I, Menzies D. Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis. Am J Respir Crit Care Med 2003;167:1472-1477. https://doi.org/10.1164/rccm.200206-626OC
  5. Surjapranata FJ, Rahaju NN. A case of Stevens-Johnson's syndrome caused by ethambutol. Paediatr Indones 1979;19:195-201.
  6. Pegram PS Jr, Mountz JD, O'Bar PR. Ethambutol-induced toxic epidermal necrolysis. Arch Intern Med 1981;141:1677-1678. https://doi.org/10.1001/archinte.1981.00340130115027
  7. Sarkar SK, Purohit SD, Sharma TN, Chawla MP, Gupta DN. Stevens-Johnson syndrome caused by streptomycin. Tubercle 1982;63:137-138. https://doi.org/10.1016/S0041-3879(82)80052-4
  8. Nunn P, Kibuga D, Gathua S, et al. Cutaneous hypersensitivity reactions due to thiacetazone in HIV-1 seropositive patients treated for tuberculosis. Lancet 1991;337:627-630. https://doi.org/10.1016/0140-6736(91)92447-A
  9. Chintu C, Luo C, Bhat G, Raviglione M, DuPont H, Zumla A. Cutaneous hypersensitivity reactions due to thiacetazone in the treatment of tuberculosis in Zambian children infected with HIV-I. Arch Dis Child 1993;68:665-668. https://doi.org/10.1136/adc.68.5.665
  10. Akula SK, Aruna AS, Johnson JE, Anderson DS. Cycloserine-induced Stevens-Johnson syndrome in an AIDS patient with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 1997;1:187-190.
  11. Kura MM, Hira SK. Reintroducing antituberculosis therapy after Stevens-Johnson syndrome in human immunodeficiency virus-infected patients with tuberculosis: role of desensitization. Int J Dermatol 2001;40:481-484. https://doi.org/10.1046/j.1365-4362.2001.01173-7.x
  12. Digwood-Lettieri S, Reilly KJ, Haith LR Jr, et al. Levofloxacin-induced toxic epidermal necrolysis in an elderly patient. Pharmacotherapy 2002;22:789-793. https://doi.org/10.1592/phco.22.9.789.34074
  13. Pitche P, Mouzou T, Padonou C, Tchangai-Walla K. Stevens-Johnson syndrome and toxic epidermal necrolysis after intake of rifampicin-isoniazid: report of 8 cases in HIV-infected patients in Togo. Med Trop (Mars) 2005;65:359-362.
  14. Roufosse F, Weller PF. Practical approach to the patient with hypereosinophilia. J Allergy Clin Immunol 2010;126:39-44. https://doi.org/10.1016/j.jaci.2010.04.011
  15. Nutman TB. Evaluation and differential diagnosis of marked, persistent eosinophilia. Immunol Allergy Clin North Am 2007;27:529-549. https://doi.org/10.1016/j.iac.2007.07.008
  16. Blumenthal KG, Youngster I, Rabideau DJ, et al. Peripheral blood eosinophilia and hypersensitivity reactions among patients receiving outpatient parenteral antibiotics. J Allergy Clin Immunol 2015;136:1288-1294. https://doi.org/10.1016/j.jaci.2015.04.005
  17. Seung KJ, Bai GH, Kim SJ, Lew WJ, Park SK, Kim JY. The treatment of tuberculosis in South Korea. Int J Tuberc Lung Dis 2003;7:912-919.
  18. Park CK, Shin HJ, Kim YI, Lim SC, Yoon JS, Kim YS, et al. Predictors of default from treatment for tuberculosis: a single center case-control study in Korea. J Korean Med Sci 2016;31:254-260. https://doi.org/10.3346/jkms.2016.31.2.254
  19. Gotlib J. World Health Organization-defined eosinophilic disorders: 2015 update on diagnosis, risk stratification, and management. Am J Hematol 2015;90:1077-1089. https://doi.org/10.1002/ajh.24196
  20. Mockenhaupt M. The current understanding of Stevens-Johnson syndrome and toxic epidermal necrolysis. Expert Rev Clin Immunol 2011;7:803-813. https://doi.org/10.1586/eci.11.66
  21. Benichou C. Criteria of drug-induced liver disorders. Report of an international consensus meeting. J Hepatol 1990;11:272-276. https://doi.org/10.1016/0168-8278(90)90124-A
  22. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P; Acute Dialysis Quality Initiative workgroup. Acute renal failure: definition, outcome measures, animal models, fluid therapy and information technology needs. The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:R204-R212. https://doi.org/10.1186/cc2872
  23. Choquet-Kastylevsky G, Intrator L, Chenal C, Bocquet H, Revuz J, Roujeau JC. Increased levels of interleukin 5 are associated with the generation of eosinophilia in drug-induced hypersensitivity syndrome. Br J Dermatol 1998;139:1026-1032. https://doi.org/10.1046/j.1365-2133.1998.02559.x
  24. Yawalkar N, Shrikhande M, Hari Y, Nievergelt H, Braathen LR, Pichler WJ. Evidence for a role for IL-5 and eotaxin in activating and recruiting eosinophils in drug-induced cutaneous eruptions. J Allergy Clin Immunol 2000;106:1171-1176. https://doi.org/10.1067/mai.2000.110922
  25. Gerson D, Sriganeshan V, Alexis JB. Cutaneous drug eruptions: a 5-year experience. J Am Acad Dermatol 2008;59:995-999. https://doi.org/10.1016/j.jaad.2008.09.015
  26. Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS). Semin Cutan Med Surg 1996;15:250-257. https://doi.org/10.1016/S1085-5629(96)80038-1
  27. Yang J, Yang X, Li M. Peripheral blood eosinophil counts predict the prognosis of drug eruptions. J Investig Allergol Clin Immunol 2013;23:248-255.
  28. Roujeau JC, Stern RS. Severe adverse cutaneous reactions to drugs. N Engl J Med 1994;331:1272-1285. https://doi.org/10.1056/NEJM199411103311906

피인용 문헌

  1. Hypersensitivity reactions to multiple anti-tuberculosis drugs vol.16, pp.2, 2019, https://doi.org/10.1371/journal.pone.0246291