아스피린과민성 환자에서 메페리딘에 의해 유발된 알레르기 반응 1예
Allergic Reaction to Meperidine in a Patient with Aspirin Idiosyncrasy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
본 증례는 아스피린/비스테로이드성 진통소염제 과민성과만성 두드러기 환자에서 대체약물로 비교적 안전하게 사용되는 아편유사체진통제인 메페리딘에 대한 IgE 매개 급성 전신두드러기 증례로 국내에서는 첫 번째 보고라는 점에서 의의가 있다. 임상에서 흔히 사용하는 약물이기 때문에 투여 후주의 깊은 관찰이 필요하며 즉시형 과민반응이 의심되는 경우에는 병인기전의 확인이 필요할 것으로 생각된다.
Abstract
Although narcotic analgesics are potent releasers of histamine, IgE-mediated allergic reactions to these drugs are rare. Here we report the case of a 56-year-old male who suffered from chronic urticarial and analgesics-induced skin rashes. He visited our allergy clinic to determine alternative analgesics before undergoing surgery. A drug provocation test showed a positive reaction to aspirin, but negative reactions to acetaminophen and celecoxib. Despite careful attention to his drug regimen, during surgery he developed generalized urticaria and flushing. Skin tests of allergy to latex, lidocaine, propofol, rocuronium, flomoxef, meperidine, palonosetron, pyridostigmine, and fentanyl yielded negative results, except for the prick and intradermal tests with meperidine. Thus, this patient had both an aspirin/non-steroidal anti-inflammatory drugs idiosyncrasy and an IgE-mediated hypersensitivity to meperidine.
참고문헌 (10)
- Levy JH, "Anaphylaxis to meperidine", Anesth Analg, 61, pp.301~303 (1982)
- 김정은, "아스피린 과민성 두드러기 환자들의 임상적 특성", 천식 및 알레르기, 30(2), pp.93~99 (2010), 대한천식알레르기학회
- Fisher MM, "Intradermal compared with prick testing in the diagnosis of anaesthetic allergy", Br J Anaesth, 79, pp.59~63 (1997)
- Lorenz W, "Anaphylactoid reactions and histamine release by barbiturate induction agents: clinical relevance and patho-mechanisms", Anesthesiology, 63, pp.351~352 (1985)
- Flacke JW, "Histamine release by four narcotics: a double-blind study in humans", Anesth Analg, 66, pp.723~730 (1987)
- Ennis M, "Histamine release induced by opioid analgesics: a comparative study using porcine mast cells", Agents Actions, 33, pp.20~22 (1991)
- Aníbarro B, "Urticaria induced by meperidine allergy", Allergy, 55, pp.305~306 (2000)
- Kim HS, "Two cases of meperidine induced localized hypersensitivity skin reaction", J Asthma Allergy Clin Immunol, 20, pp.130~134 (2000)
- Slowik SM, "Aspirin desensitization in a patient with aspirin sensitivity and chronic idiopathic urticaria", Ann Allergy Asthma Immunol, 102, pp.171~172 (2009)
- Simon RA, "Prevention and treatment of reactions to NSAIDs", Clin Rev Allergy Immunol, 24, pp.189~198 (2003)