腎不全が出現し死の転帰をたどった薬剤性過敏症症候群の2例

・薬剤性過敏症症候群（drug-induced hypersensitivity syndrome：DIHS）の既往を有 し，原因薬の再投与によって腎不全をきたし死亡した2例を報告した．

・2例とも従来のDIHSの経過とは異なり，原因薬の再投与時には早期に皮疹が出現し，急速に腎不全に至るという特徴的な経過を有した．

・高齢患者における薬剤管理の重要性が示唆された．

（「症例のポイント」より）

　

Two fatal cases of drug-induced hypersensitivity syndrome causing renal failure

　

Kageyama, Reiko1）Kaneko, Yasuhito2）Hashizume, Hideo2） 1）Department of Dermatology, Hamamatsu University School of Medicine 2）Department of Dermatology, Shimada Municipal Hospital

　

Drug-induced hypersensitivity syndrome（ DIHS） is a life-threatening drug adverse reaction characterized by emergence of serious organ dysfunction and its mortality is reportedly around 10％. We described two fatal DIHS cases with rapid progression of renal failure during the disease course. In both of the cases, they had a history of drug eruption and progressively developed DIHS after re-administration of the culprit drugs. They had the characteristic course that the drug eruption had appeared earlier than DIHS cases that have been ever reported and developed rapidly severe renal failure causing death. The present cases alert us to pay a special attention for previous history about drug adverse reactions.