修正型電気痙攣療法時に薬物過敏反応を疑う著明な紅斑を認めたが，使用薬物を変更せずに治療継続できた症例

Suspected Drug Hypersensitivity with Significant Erythema during Modified Electroconvulsive Therapy, Treated Successfully without Medication Change

要旨

　修正型電気痙攣療法（modified electroconvulsive therapy：mECT）4回目施行時のスキサメトニウム投与後，前胸部を中心とした著明な紅斑を呈したが，バイタルサインや呼吸状態の変化がなかったことから薬物変更せず，全18回のmECTが施行できた症例を経験したので報告する。

　A 44-year-old woman undergoing modified electroconvulsive therapy（mECT）for treatment-resistant depression developed transient chest-centered erythema after the administration of suxamethonium beginning at the fourth mECT session. The erythema spread but resolved within 10 min without systemic symptoms. The patient’s histamine and tryptase levels were not elevated, which suggested non-IgE-mediated hypersensitivity. The patient’s reaction to the suxamethonium was mild and did not require the suxamethonium’s discontinuation. Despite the recurrence of erythema in the patient’s subsequent mECT sessions, the electroconvulsive treatment for depression was successfully completed. This case underscores the importance of distinguishing non-IgE-mediated hypersensitivity from IgE-mediated hypersensitivity in order to avoid unnecessary drug avoidance and ensure the continuation of effective therapies.