세 가지 이상의 항혈소판제 약물과민반응 환자에서 성공적인 급속 순차적 탈감작요법 1예
Successful sequential desensitization in a patient with drug hypersensitivity to three kinds of antiplatelet agents
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Antiplatelet agents, such as aspirin, clopidogrel, and cilostazol, are essential for the treatment and prevention of cardiovascular, cerebrovascular, and peripheral vascular diseases. A 53-year-old male with aspirin hypersensitivity developed dizziness, which was caused by severe stenosis of the left vertebral artery. Clopidogrel was administerted, but discontinued due to generalized urticaria and angioedema. As an alternative drug, cilostazol was administered, but discontinued again because of the same adverse reactions. Desensitization was planned as other alternative antiplatelet agents were not available. Initially, aspirin desensitization was successfully performed. One day after aspirin desensitization, clopidogrel desensitization was sequentially done successfully. After a few months, cilostazole desensitization was performed. During the follow-up period, he had to stop aspirin and cilostazol twice to prevent the risk of bleeding after a procedure and an operation. After discontinuing medicines, sequential desensitization of aspirin and cilostazol was successfully performed. Physicians should be aware that drug hypersensitivity could be induced by various kinds of antiplatelet agents and that desensitization could be the treatment of choice unless alternative medicines are available.
Abstract
Antiplatelet agents, such as aspirin, clopidogrel, and cilostazol, are essential for the treatment and prevention of cardiovascular, cerebrovascular, and peripheral vascular diseases. A 53-year-old male with aspirin hypersensitivity developed dizziness, which was caused by severe stenosis of the left vertebral artery. Clopidogrel was administerted, but discontinued due to generalized urticaria and angioedema. As an alternative drug, cilostazol was administered, but discontinued again because of the same adverse reactions. Desensitization was planned as other alternative antiplatelet agents were not available. Initially, aspirin desensitization was successfully performed. One day after aspirin desensitization, clopidogrel desensitization was sequentially done successfully. After a few months, cilostazole desensitization was performed. During the follow-up period, he had to stop aspirin and cilostazol twice to prevent the risk of bleeding after a procedure and an operation. After discontinuing medicines, sequential desensitization of aspirin and cilostazol was successfully performed. Physicians should be aware that drug hypersensitivity could be induced by various kinds of antiplatelet agents and that desensitization could be the treatment of choice unless alternative medicines are available.
참고문헌 (18)
- Hofmeier KS, "Hypersensitivity reactions to modern antiplatelet and anticoagulant drugs", Allergo J Int, 24, pp.58~66 (2015)
- Nizankowska-Mogilnicka E, "EAACI", GA2LEN guideline: aspirin provocation tests for diagnosis of aspirin hypersensitivity, 2007, pp.62, 1111~1118
- Campbell KL, "Clopidogrel hypersensitivity: clinical challenges and options for management", Expert Rev Clin Pharmacol, 3, pp.553~561 (2010)
- Kang SY, "Drug-induced hypersensitivity syndrome", drug reaction with eosinophilia and systemic symptoms syndrome induced by cilostazol and carbamazepine, 2012, pp.39, 723~724
- Fernando SL, "Rapid and sequential desensitization to both aspirin and clopidogrel", Intern Med J, 40, pp.596~599 (2010)
- Cernadas JR, "General considerations on rapid desensitization for drug hypersensitivity - a consensus statement", Allergy, 65, pp.1357~1366 (2010)
- Johansson SG, "Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003", J Allergy Clin Immunol, 113, pp.832~836 (2004)
- Turan TN, "Treatment of atherosclerotic intracranial arterial stenosis", Stroke, 40, pp.2257~2261 (2009)
- 김철우, "아스피린 및 비스테로이드성 항염증제 과민반응", 대한내과학회지, 87(6), pp.659~664 (2014), 대한내과학회[DOI]
- Jenneck C, "Pathogenesis, diagnosis, and treatment of aspirin intolerance", Ann Allergy Asthma Immunol, 99, pp.13~21 (2007)
- Rachel U. Lee, "Aspirin-Exacerbated Respiratory Disease: Evaluation and Management", Allergy, Asthma & Immunology Research, 3(1), pp.3~10 (2011), 대한천식알레르기학회
- Woessner KM, "Aspirin desensitization for cardiovascular disease", Curr Opin Allergy Clin Immunol, 15, pp.314~322 (2015)
- Makkar K, "Rash with both clopidogrel and ticlopidine in two patients following percutaneous coronary intervention with drug-eluting stents", Ann Pharmacother, 40, pp.1204~1207 (2006)
- Fajt M, "Clopidogrel hypersensitivity: a novel multi-day outpatient oral desensitization regimen", Ann Pharmacother, 44, pp.11~18 (2010)
- Felix-Getzik E, "Prasugrel use in a patient allergic to clopidogrel:effect of a drug shortage on selection of dual antiplatelet therapy", Am J Health Syst Pharm, 70, pp.511~513 (2013)
- Lokhandwala J, "Allergic reactions to clopidogrel and cross-reactivity to other agents", Curr Allergy Asthma Rep, 11, pp.52~57 (2011)
- Chin N, "Oral antiplatelet agent hypersensitivity and cross-reactivity managed by successful desensitisation", Asia Pac Allergy, 5, pp.51~54 (2015)
- 이애라, "일차 항결핵제 모두에 과민반응을 보인 환자의 성공적 탈감작 결핵 치료 1예", Allergy Asthma & Respiratory Diseases, 1(4), pp.395~399 (2013), 대한 소아알레르기 호흡기학회