아스피린 과민성을 동반하지 않은 Diclofenac에 의한 아나필락시스 환자 2예
Two cases of anaphylaxis to diclofenac with aspirin tolerance
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참고문헌
초록
저자들은 천식이나 두드러기의 병력이 없는 정상인에서 Diclofenac 근주 후 전신 두드러기와 함께 저혈압이 발생한 2예를 경험하였다. 음식물이나 약물 등 달리 의심할 만한 원인물질에 노출이 없었고, 전조 증상없이 Diclofenac 투여 후 갑자기 환자의 증상이 발생하였으며 아스피린 경구유발검사 결과가 음성인 점에 비추어 볼때 Cyclo-oxygenase 억제 기전이 아닌 IgE 매개에 의해 발생한 Diclofenac 아나필락시스라 추론할 수 있겠으나 자세한 기전은 추가적인 연구가 필요하다.
Abstract
Anaphylaxis is an acute life-threatening reaction, usually mediated by immunologic and non- immunologic mechanisms. Non-steroidal anti-inflammatory drugs (NSAIDs) can produce anaphylactic reactions by different pathogenic mechanisms. The most of these reactions are elicited by different NSAIDs depending on the potency of the cyclooxygenase inhibition, but other reactions provoked by IgE-dependent mechanism. The NSAIDs most often involved in these kinds of reactions are pyrazolones and aspirin. Diclofenac is a widely used NSAID derivative of phenylacetic acid. Anaphylaxis to diclofenac with aspirin tolerance has been rarely described. Here we report two cases of selective anaphylaxis to diclofenac with good tolerance to aspirin. It may be suggested by IgE-dependent reaction, not by cyclooxygenase inhibition
참고문헌 (16)
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