경구 유발시험으로 진단한 Pyrazinamide 유발 두드러기와 혈관부종: 증례 보고
Pyrazinamide-Induced Urticaria and Angioedema: a Case Report
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초록
항결핵제에 의한 즉시형 과민반응은 드물게 발생하지만, 국내의 결핵 유병률이 높고 항결핵제가 자주 처방되는 약물임을 고려할 때, 치료시 주의를 기울이는 것이 필요하겠다.
Abstract
Pyrazinamide (PZA) is an anti-tuberculosis drug and an essential component of the standard four-drug regimen for tuberculosis. Here, we report a case of immediate angioedema secondary to PZA administration intended for pulmonary tuberculosis treatment. A previously healthy 48-year-old woman was diagnosed with pulmonary tuberculosis and tuberculous lymphadenitis. Thirty minutes after taking the first dose of isoniazid, rifampicin, pyrazinamide, and ethambutol, the patient developed facial edema, generalized rash, and dizziness. An oral provocation test was performed on the four drugs, and 1,000 mg pyrazinamide showed a positive result characterized by 50 minutes of urticaria, angioedema, and hypotension. As the prevalence of tuberculosis increases, prescriptions for anti-tuberculosis drugs may increase as well. Clinicians should be aware of the possibility of immediate hypersensitivity as well as delayed hypersensitivity to anti-tuberculosis drugs.
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