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에이즈 환자에서 Abacavir에 의해 발생한 과민반응 1예

A Case of Hypersensitivity Reaction Induced by Abacavir in an AIDS Patient

  • 고성주 (제주대학교 의과대학 내과학교실) ;
  • 허상택 (제주대학교 의과대학 내과학교실) ;
  • 김진석 (제주대학교 의과대학 내과학교실) ;
  • 김영리 (제주대학교 의과대학 진단검사의학교실) ;
  • 김재왕 (제주대학교 의과대학 피부과학교실)
  • Ko, Seong-Joo (Department of Internal Medicine, Jeju National University School of Medicine) ;
  • Heo, Sang-Taek (Department of Internal Medicine, Jeju National University School of Medicine) ;
  • Kim, Jin-Seok (Department of Internal Medicine, Jeju National University School of Medicine) ;
  • Kim, Young-Ree (Department of Laboratory Medicine, Jeju National University School of Medicine) ;
  • Kim, Jae-Wang (Department of Dermatology, Jeju National University School of Medicine)
  • 발행 : 2012.07.01

초록

Abacavir는 부작용이 적어 최근 많이 사용하는 항바이러스제이지만 드물게 치명적인 과민반응을 일으킬 수 있다. 저자들은 abacavir 투여 후 피부발진, 부종, 호흡곤란의 증상을 보인 환자에서 HLA-B$^{\ast}$5701 유전형을 확인하여 abacavir에 의한 과민반응임을 진단하였으며, 본 증례는 조기에 약물을 중단하여 치유된 국내 첫 환자에 대한 보고이다. Abacavir에 의한 과민반응이 드문 부작용이지만 생명에 위험이 될 수 있으므로 주의 깊은 관찰이 필요하며, 약물 중단 등 조기에 적절한 대처가 중요하다.

Abacavir is a nucleoside reverse transcriptase inhibitor that is commonly used in HIV-infected patients. A well-known and potentially life-threatening side effect of abacavir is allergic hypersensitivity reaction. A screening test for the HLA-B*5701 allele is currently used to predict the risk of hypersensitivity reaction to abacavir. This test, however, may be less useful in Korea, because of the low prevalence of HLA-B*5701. A 52-year-old male with HIV infection was referred to our hospital because of suspected side-effects of antiviral agents and lymph node enlargement of the neck. He suffered from a fever, generalized edema, skin rash of the whole body, and difficulty breathing after starting antiviral agents. Suspected as a hypersensitivity reaction resulting from drug side-effects, prescription of abacavir was stopped. The patient subsequently recovered. The presence of the HLA-B*5701 allele was confirmed by polymerase chain reaction-sequencing based typing (PCR-SBT).

키워드

참고문헌

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