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페니토인에 의한 횡문근융해증이 동반된 항경련제 과민반응 증후군
김영훈 ( Young Hoon Kim ),이채욱 ( Chae Uk Lee ),김기호 ( Ki Ho Kim ),김상호 ( Sang Ho Kim ),신봉철 ( Bong Chul Shin ),서효림 ( Hyo Rim Seo ),김보경 ( Bo Kyung Kim ),허정훈 ( Jeong Hun Heo ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.1
Anticonvulsant hypersensitivity syndrome (AHS) is a multisystemic disorder with cutaneous changes and typical blood abnormalities that may be triggered by any of the aromatic anticonvulsant drugs. Hepatic involvement is most common among internal organ involvements. Rhabdomyolysis is a rare manifestation of AHS. We present the case of a woman who, following phenytoin treatment, developed AHS with rhabdomyolysis. A 21-year-old woman was consulted to Allergy Clinic due to fever, rash, myalgia, and marked periorbital and facial edema that developed 10 days after the start of phenytoin therapy for seizure. Her hospital course was remarkable with an increased serum creatine phosphokinase level of 8,576 IU/liter. Peripheral blood cell counts showed eosinophilia (1,100/μL) and thrombocytopenia (112,000/μL). Liver function tests revealed increased levels of liver enzymes (AST/ALT=1,0011/611 IU/L) and hyperbilirubinemia (total bilirubin/direct bilirubin=2.9/1.6 mg/dL). After the discontinuation of phenytoin and treatment with oral prednisolone for three weeks, her skin lesion and laboratory abnormalities improved. (Korean J Asthma Allergy Clin Immunol 2007;27:66-69)