薬剤性過敏症症候群
WordNet
- reason or establish by induction
- cause to arise; "induce a crisis" (同)bring_on
- produce electric current by electrostatic or magnetic processes (同)induct
- cause to do; cause to act in a specified manner; "The ads induced me to buy a VCR"; "My children finally got me to buy a computer"; "My wife made me buy a new sofa" (同)stimulate, cause, have, get, make
- cause to occur rapidly; "the infection precipitated a high fever and allergic reactions" (同)stimulate, rush, hasten
- act later than planned, scheduled, or required; "Dont delay your application to graduate school or else it wont be considered"
- time during which some action is awaited; "instant replay caused too long a delay"; "he ordered a hold in the action" (同)hold, time_lag, postponement, wait
- the act of delaying; inactivity resulting in something being put off until a later time (同)holdup
- cause to be slowed down or delayed; "Traffic was delayed by the bad weather"; "she delayed the work that she didnt want to perform" (同)detain, hold_up
- use recreational drugs (同)do drugs
- administer a drug to; "They drugged the kidnapped tourist" (同)dose
- a substance that is used as a medicine or narcotic
- a pattern of symptoms indicative of some disease
- a complex of concurrent things; "every word has a syndrome of meanings"
- not as far along as normal in development
PrepTutorEJDIC
- 〈人〉‘に'『勧めて』(…)『させる』 / …‘を'『引き起こす』,もたらす(cause) / 〈電気〉‘を'誘導する / …‘を'帰納する
- …'を'『延期する』,延ばす / 〈事故などが〉…'を'『遅らせる』 / 『ぐずぐずする』,『手間取る』 / 『遅れ』,遅延 / 『延期』,猶予
- 『薬』,薬品,薬剤 / 『麻薬』,麻酔剤 / 〈人〉‘に'薬(特に麻酔剤)を与える / 〈飲食物〉‘に'(麻酔薬・毒薬などの)薬を混ぜる
- (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
UpToDate Contents
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English Journal
- Drug-induced hypersensitivity syndrome: recent advances in the diagnosis, pathogenesis and management.
- Shiohara T1, Kano Y, Takahashi R, Ishida T, Mizukawa Y.
- Chemical immunology and allergy.Chem Immunol Allergy.2012;97:122-38. doi: 10.1159/000335624. Epub 2012 May 3.
- Drug-induced hypersensitivity syndrome (DIHS), also referred to as drug reaction with eosinophilia with systemic symptoms, is a life-threatening multiorgan system reaction caused by a limited number of drugs such as anticonvulsants. This syndrome is characterized by fever, rash, lymphadenopathy, hep
- PMID 22613858
- A case of sulphasalazine-induced DRESS syndrome with delayed acute interstitial nephritis.
- Augusto JF1, Sayegh J, Simon A, Croue A, Chennebault JM, Cousin M, Subra JF.
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.Nephrol Dial Transplant.2009 Sep;24(9):2940-2. doi: 10.1093/ndt/gfp277. Epub 2009 Jun 9.
- Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a rare and severe drug-induced hypersensitivity syndrome characterized by haematological abnormalities (hypereosinophilia and/or mononucleosis) and multiorgan involvement. Renal failure has been rarely described. We report the cas
- PMID 19509026
- Human herpesvirus 6 infection as a risk factor for the development of severe drug-induced hypersensitivity syndrome.
- Suzuki Y1, Inagi R, Aono T, Yamanishi K, Shiohara T.
- Archives of dermatology.Arch Dermatol.1998 Sep;134(9):1108-12.
- BACKGROUND: Drug-induced hypersensitivity syndrome is characterized by a severe, potentially fatal, multiorgan hypersensitivity reaction that usually appears after prolonged exposure to certain drugs. Its delayed onset and clinical resemblance to infectious mononucleosis suggest that underlying vira
- PMID 9762023
Japanese Journal
- A proposed consensus nomenclature for the drug-induced delayed multiorgan hypersensitivity syndrome
★リンクテーブル★
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- 英
- drug-induced hypersensitivity syndrome DIHS
- 同
- drug rash with eosinophilia and systemic symptoms DRESS,drug-induced delayed multiorgan hypersensitivity syndrome DIDMOS
- 関
- 薬疹
概念
- 高熱と臓器障害を伴う薬疹で、医薬品中止後も遷延化する。多くの場合、発症後2-3週間後にHHV-6の再活性化を生じる。(参考1)
病因
原因薬物
- 原因薬物としては芳香族抗てんかん薬とスルホンアミド系抗菌薬が最も多い (参考2)
- 参考3
病態
- 特定の薬剤を服用した2-6週間後に突然の発熱と紅斑を来たし、ついには紅皮症を呈する。
- リンパ節腫脹、血液学的異常、肝機能障害を伴う。
- 肺炎、腎不全、心筋炎、甲状腺炎、神経学的症状を呈することがある。(参考2)
症状
身体所見
検査
- 血算:白血球増多、異型リンパ球有り、好酸球増多
- 血清学的検査:IgM-抗HHV-6抗体陽性
検査異常の出現頻度
- 参考2
- 肝炎:51%
- 間質性腎炎:11%
- 血液学的異常(好酸球増多、異型単核球):30%
診断基準
- 参考1
- 1. 限られた薬剤投与後に遅発性に生じ、急速に拡大する紅斑。多くの場合、紅皮症に移行する
- 2. 原因薬剤中止後も2週間以上遷延する
- 3. 38 ℃以上の発熱
- 4. 肝機能障害
- 5. 血液学的異常:a、b、c のうち1 つ以上
- a. 白血球増多(11,000/mm3 以上)
- b. 異型リンパ球の出現(5%以上)
- c. 好酸球増多(1,500/mm3 以上)
- 典型DIHS:1 - 7 すべて
- 非典型DIHS:1 - 5 すべて。ただし4 に関しては、その他の重篤な臓器障害をもって代えることができる。
治療
- 薬剤の中止、全身ステロイド療法(要するに静注ということか)。(参考1)
予後
- 完全に治癒する。重症例では生命予後不良。(参考1)
参考
- 1. 重篤副作用疾患別対応マニュアル 薬剤性過敏症症候群
- http://www.mhlw.go.jp/topics/2006/11/dl/tp1122-1a09.pdf
- 2. [charged] Drug eruptions - uptodate [1]
- CLASSIC DRUG REACTION PATTERNSの1項目として記載。
- www.eiken.co.jp/modern_media/backnumber/pdf/MM1012_01.pdf
国試
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- 誘発する、誘導する、誘起する、導入する、引き起こす
- 関
- cause、challenge、derivation、elicit、elicitation、evocation、evoke、guidance、induction、inductive、introduce、introduction、precipitate、provocation、provoke、spark
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- 関
- delayed-type、late、late-onset、protracted、tardive、tardus、tardy
[★]
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- hypercalcaemia induced pancreatitis 高カルシウム血症による膵炎
[★]
- 関
- lag、retard、retardation
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- 関
- multiple organ