간경변증 환자에서 면역글로불린으로 치료한 독성표피괴사융해 1예
Toxic epidermal necrolysis treated with high-dose intravenous immunoglobulin in a patient with liver cirrhosis
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초록
저자들은 복수를 동반한 간경변증 환자에서 lamotrigine에 의해서 발생한 스테로이드 저항성 TEN에 대해서 고용량의 IVIG로 치료하여 부작용의 발생 없이 신속한 임상적 호전을 경험하였고, 진행된 간경변증 환자에서도 안전하게 사용할 수 있었기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Toxic epidermal necrolysis (TEN) is a very dramatic, life-threatening mucocutaneous drug reaction. TEN is characterized by extensive detachment of the epidermis. A 53-year-old man with advanced liver cirrhosis had been treated with lamotrigine (Lamictal®) for a convulsive disorder for 7 months before being admitted to hospital with diffuse erythematous maculopapular lesions with extensive confluence that developed on the neck, chest, back, upper arms and thighs and bled spontaneously. The skin lesions worsened rapidly during the initial period of admission despite systemic steroid treatment. Therefore, we tried treating the TEN with high-dose intravenous immunoglobulin (IVIG; 0.5 g/kg/day for 4 consecutive days). The progression of the epidermal detachment stopped within 3 days of starting the IVIG treatment and re-epithelialization was completed in 5 weeks without significant side effects of IVIG. Here, we report a case of life-threatening TEN treated with high-dose IVIG in a patient with advanced liver cirrhosis. (Korean J Med 77:S1119-S1123, 2009)
참고문헌 (12)
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