CAJ | 학술논문

1例82岁男性冠状动脉粥样硬化性心脏病患者,注射碘克沙醇注射液约60 ml行动脉造影术.术后第2天患者全身皮肤出现红色斑疹伴瘙痒,停用阿司匹林、比索洛尔、阿托伐他汀、氯吡格雷等所有药物,给予抗过敏治疗8d,症状逐渐加重,考虑为碘克沙醇引起的迟发型过敏反应.实验室检查示:白细胞计数10.1×109/L,中性粒细胞0.79,嗜酸粒细胞0.02,超敏C反应蛋白13.9 mg/L,降钙素原0.189 μg/L.诊断为重症多形红斑型药疹.给予甲泼尼龙琥珀酸钠、夫西地酸钠、利多卡因+地塞米松加入碳酸氢钠溶液护理口腔、生理盐水+庆大霉素+地塞米松湿敷唇部等治疗后症状缓解.
1례82세남성관상동맥죽양경화성심장병환자,주사전극사순주사액약60 ml행동맥조영술.술후제2천환자전신피부출현홍색반진반소양,정용아사필림、비색락이、아탁벌타정、록필격뢰등소유약물,급여항과민치료8d,증상축점가중,고필위전극사순인기적지발형과민반응.실험실검사시:백세포계수10.1×109/L,중성립세포0.79,기산립세포0.02,초민C반응단백13.9 mg/L,강개소원0.189 μg/L.진단위중증다형홍반형약진.급여갑발니룡호박산납、부서지산납、리다잡인+지새미송가입탄산경납용액호리구강、생리염수+경대매소+지새미송습부진부등치료후증상완해.
An 82-year-old male patient with coronary atherosclerosis heart disease received iodixanol injection 60 ml for arteriography.On day 2 after operation,the patient developed erythema multiforme and itching.Aspirin,bisoprolol,atorvastatin,and clopidogrel were stopped and anti-allergy treatments were given.Eight days later,the symptoms worsened gradually.Delayed anaphylactic reaction induced by iodixanol was considered.Laboratory examination showed the following results:white blood cell count 10.1 × 109/L,neutrophils 0.79,eosinophils 0.02,high sensitivity C reaction protein 13.9 mg/L,and procalcitonin 0.189 μg,/L.Severe erythema multiforme was diagnosed.The patient's symptoms improved after treatments with methylprednisolone sodium succinate,sodium fusidate,mouth care (lidocaine + dexamethasone + sodium bicarbonate solution),wet dressing for lip (normal saline + gentamicin + dexamethasone).