1차 및 2차 항결핵제에 의한 DRESS (drug reaction with eosinophilia and systemic symptom) 증후군 1예와 문헌고찰

• Published in: Allergy asthma & respiratory disease pp. 111 - 116
• Main Authors: 황영훈, 장동연, 강성윤, 손경희, 강동윤, 이창훈, 강혜련
• Format: Journal Article
• Language: Korean
• Published: 대한 소아알레르기 호흡기학회 01-03-2017
• Subjects: 소아과학
• ISSN: 2288-0402; 2288-0410
• DOI: 10.4168/aard.2017.5.2.111

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially fatal drug-induced systemic hypersensitivity response characterized by erythematous eruption, fever, leukocytosis with eosinophilia, and internal organ involvement.
Antitubercular agents are potential causative agents for DRESS syndrome but difficult to verify as a culprit drug, since antitubercular agents are coadministered as a combination regimen. A 42-year-old female with endobronchial tuberculosis was diagnosed with DRESS syndrome after 4-week treatment of isoniazid, rifampicin, ethambutol, and pyrazinamide with prednisolone 50 mg. All the antitubercular agents were stopped and replaced with levofloxacin, cycloserine, p-aminosalicylic acid, and kanamycin.
However, severe exacerbation of DRESS syndrome compelled the patient to discontinue the administration of the second-line antitubercular agents. Two months later, the patient underwent a patch test for all the antitubercular agents which had been used, and the results showed positivity to isoniazid and cycloserine. We report a rare case of DRESS syndrome that reacted to cycloserine as well as isoniazid. Development of coreactivity to other drugs should be differentiated with a flare-up reaction in the management of DRESS syndrome. KCI Citation Count: 0