알로퓨리놀 사용 후 발생한 진성 적혈구 감소증 1예
Allopurinol hypersensitivity syndrome and pure red cell aplasia associated with allopurinol treatment
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초록
Allopurinol은 고요산증 치료를 위해 많이 사용되고 있는 약제이며 가벼운 위장장애 및 피부발진을 유발할 수 있다. 고혈압, 만성신기능부전 등의 기저질환이 있는 경우 드물게 심한 표피 박탈성 피부발진과 간장, 신장장애를 동반하는 allopurinol hypersensitivity syndrome을 야기 시키며 이때는 신속한 진단과 약물투여 중지를 해야 한다. Allopurinol은 약제사용 6～8주 후 급성 진성 적혈구 감소증을 드물게 유발할 수 있다. 저자들은 만성신기능부전을 가진 환자에서 allopurinol 사용 8주 경부터 allopurinol hypersensitivity syndrome과 진성 적혈구 감소증이 병발한 경우를 경험하여 보고 하는 바이다.
Abstract
Allopurinol is widely used to reduce serum uric acid levels and, generally, has mild side effects. Rarely, allopurinol hypersensitivity syndrome occurs and this consists of severe systemic skin lesions, fever, reduced kidney and liver function, and leukocytosis with eosinophilia. Extremely rarely, allopurinol-induced pure red cell aplasia is reported. We report a case of allopurinol hypersensitivity syndrome and pure red cell aplasia following allopurinol therapy for eight weeks and the disease response to steroid therapy in a patient with chronic renal insufficiency.
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