Allergy Asthma Respir Dis.
2015 Jul;3(4):297-301. 10.4168/aard.2015.3.4.297.
Successful readministration of second-line antituberculous agents in a patient with near-fatal drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome
- Affiliations
-
- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. helenmed@snu.ac.kr
- 2Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
- 3Regional Pharmacovigilance Center, Seoul National University Hospital, Seoul, Korea.
- 4Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
- KMID: 2218661
- DOI: http://doi.org/10.4168/aard.2015.3.4.297
Abstract
- For the treatment of multidrug-resistant (MDR) tuberculosis, maintenance of appropriate antituberculous agents is essential because of its low cure rate and high dropout rate. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced systemic hypersensitivity response resulting in cessation of causative agents. In cases of second-line antituberculous agent-induced DRESS, it is extremely difficult to find other replacement medications to cure MDR tuberculosis. A 53-year-old male who had taken the second-line antituberculous agents (cycloserine, streptomycin, p-aminosalicylic acid, and prothionamide) as well as pyrazinamide for 5 weeks experienced DRESS syndrome accompanying hepatic coma. His symptoms improved with discontinuation of antituberculous agents and administration of high-dose methylprednisolone for 1 month. To resume the antituberculous medication, second-line antituberculous agents were administered one by one using a rapid desensitization protocol. While kanamycin, levofloxacin, and cycloserine were successfully readministered, p-aminosalicylic acid- and prothionamide-induced cutaneous hypersensitivity symptoms were relatively mild compared to previous reactions. Herein, we report a case of successfully treated MDR tuberculosis having a history of fatal DRESS syndrome to antituberculous agents using the rapid desensitization protocol.
MeSH Terms
-
Aminosalicylic Acid
Antitubercular Agents
Cycloserine
Desensitization, Immunologic
Drug Hypersensitivity Syndrome*
Hepatic Encephalopathy
Humans
Hypersensitivity
Kanamycin
Levofloxacin
Male
Methylprednisolone
Middle Aged
Patient Dropouts
Pyrazinamide
Streptomycin
Tuberculosis
Tuberculosis, Multidrug-Resistant
Aminosalicylic Acid
Antitubercular Agents
Cycloserine
Kanamycin
Methylprednisolone
Pyrazinamide
Streptomycin
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Drug Reaction with Eosinophilia and Systemic Symptom Syndrome Due to Everolimus: A Case Report
- Eosinophilic Polymyositis and DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) Syndrome by Antitubercular Agents
- Diagnosis and Management of DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) Syndrome
- Rasagiline Induced Drug Rash with Eosinophilia and Systemic Symptoms Syndrome: A Case Report
- DRESS (drug reaction with eosinophilia and systemic symptom) syndrome caused by both first-line and second-line antitubercular medications: A case report with a brief literature review
