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증례 : 알레르기 ; 아스피린과민성 환자에서 메페리딘에 의해 유발된 알레르기 반응 1예
서민교 ( Min Gyo Seo ),노태훈 ( Tae Hoon No ),정희정 ( Heui Jeong Jeong ),김용완 ( Young Wan Kim ),김용한 ( Young Han Kim ),정재원 ( Jae Won Jung ),박찬선 ( Chan Sun Park ) 대한내과학회 2015 대한내과학회지 Vol.88 No.6
본 증례는 아스피린/비스테로이드성 진통소염제 과민성과 만성 두드러기 환자에서 대체약물로 비교적 안전하게 사용되는 아편유사체진통제인 메페리딘에 대한 IgE 매개 급성 전신두드러기 증례로 국내에서는 첫 번째 보고라는 점에서 의의가 있다. 임상에서 흔히 사용하는 약물이기 때문에 투여 후주의 깊은 관찰이 필요하며 즉시형 과민반응이 의심되는 경우에는 병인기전의 확인이 필요할 것으로 생각된다. Although narcotic analgesics are potent releasers of histamine, IgE-mediated allergic reactions to these drugs are rare. Here we report the case of a 56-year-old male who suffered from chronic urticarial and analgesics-induced skin rashes. He visited our allergy clinic to determine alternative analgesics before undergoing surgery. A drug provocation test showed a positive reaction to aspirin, but negative reactions to acetaminophen and celecoxib. Despite careful attention to his drug regimen, during surgery he developed generalized urticaria and flushing. Skin tests of allergy to latex, lidocaine, propofol, rocuronium, flomoxef, meperidine, palonosetron, pyridostigmine, and fentanyl yielded negative results, except for the prick and intradermal tests with meperidine. Thus, this patient had both an aspirin/non-steroidal anti-inflammatory drugs idiosyncrasy and an IgE-mediated hypersensitivity to meperidine. (Korean J Med 2015;88:732-736)
( Jun Gyo Gwon ),( Ju Wang Jang ),( Se Kwang Park ),( Se Uk Oh ),( Ho Song Kang ),( Joung Soo Kim ),( Hyun-min Seo ) 대한피부과학회 2020 大韓皮膚科學會誌 Vol.58 No.9
Background: Few studies have investigated the association between Behçet disease (BD) and cardiovascular disease (CVD). The aim of this study was to investigate the risk of various CVDs in patients with BD. Objective: The aim of this study was to investigate the risk of various CVD in patients with BD. Methods: Between 2003 and 2015, we performed a retrospective cohort study involving patients with BD selected from Korea’s National Health Insurance Service-National Sample Cohort database and age- and sex-matched controls. Age- and sex-matched controls were selected randomly from the NHIS-NSC database at a frequency of 1:5. Results: Among the 998 patients with BD and the 4,990 controls studied, patients with BD showed significantly higher risk for angina pectoris (adjusted Hazard Ratio [HR] 1.522, 95% confidence interval [CI] 1.020∼2.273; p=0.04) and peripheral arterial disease (adjusted HR 2.939, 95% CI 1.296∼6.664; p=0.01) than the controls. The cumulative incidence rates of these diseases in patients with BD were also significantly higher than those in the controls. Conclusion: Patients with BD showed independent risk for angina pectoris and peripheral arterial disease. (Korean J Dermatol 2020;58(9):608∼613)
( Eun-gyo Jeong ),( Sung Shim Cho ),( Sang-hoon Lee ),( Kang-min Lee ),( Seo-kyung Woo ),( Yoongoo Kang ),( Jae-seung Yun ),( Seon-ah Cha ),( Yoon-jung Kim ),( Yu-bae Ahn ),( Seung-hyun Ko ),( Jung-mi 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.5
Background/Aims: As the prevalence of diabetes mellitus and its complications increase rapidly, diabetic foot ulcers (DFUs), which are a major diabetic complication, are expected to increase. For prevention and effective treatment, it is important to understand the clinical course of DFUs. The aim of this study was to investigate the natural course and predictors of amputation in patients with DFUs who required hospitalization Methods: A total of 209 patients with type 2 diabetes, aged 30 to 85 years, who visited emergency department or needed hospitalization due to DFUs were consecutively enrolled from May 2012 to January 2016, by retrospective medical record review. The main outcome was lower extremity amputation (LEA). Results: Among 192 patients who completed follow-up, 113 patients (58.9%) required LEAs. Compared to patients without amputation, baseline levels of white blood cell counts and C-reactive protein were higher in patients with amputation. In addition, bone and joint involvement was more frequently observed in patients with amputation. Multivariable regression analysis revealed that combined infection (odds ratio [OR], 11.39; 95% confidence interval [CI], 2.55 to 50.93; p = 0.001) and bone or joint involvement (OR, 3.74; 95% CI, 1.10 to 12.70; p = 0.035) were significantly associated with an increased risk of LEA. Conclusions: The depth of the wound and combined infection of DFU, rather than the extent of the wound, were significant prognostic factors of LEAs in patients with type 2 diabetes.