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전신적 코티코스테로이드 투여 후 발생한 즉시형 과민반응 1예
이지향 ( Ji-hyang Lee ),오혜선 ( Hye-seon Oh ),권병수 ( Byoung Soo Kwon ),박형준 ( Hyngjun Park ),박소영 ( Soyoung Park ),김정현 ( Jung-hyun Kim ),김효정 ( Hyo-jung Kim ),권혁수 ( Hyouk-soo Kwon ),조유숙 ( You Sook Cho ),문희범 ( 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.5
Immediate-type hypersensitivity responses to systemic corticosteroids are rare despite their widespread use. It is still controversial whether the responses rarely occur or are underdiagnosed in clinical settings. Many cases probably remain underdiagnosed because the symptoms often mimic symptoms of underlying diseases. This case report describes a 73-year-old man who had immediate hypersensitivity reactions after intravenous administration of hydrocortisone, which was primarily intended to prevent hypersensitivity reactions to contrast media. Whole body rash with pruritus developed shortly after the steroid injection. Since the patient already experienced rash and itching sense after contrast media and antihistamine injection, we conducted skin testing to figure out which drug triggered the hypersensitivity reactions. Intradermal skin tests revealed a positive response to hydrocortisone sodium succinate, which suggested his hypersensitivity reactions were developed by hydrocortisone. Being a common therapy for allergic reaction, corticosteroids themselves are rarely suspected of causing hypersensitivity reactions. Considering there is no typical symptom or standard diagnostic test, awareness of corticosteroid hypersensitivity reactions is of importance to make the diagnosis. (Allergy Asthma Respir Dis 2016:4:378-381)