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      저자 : Remedios Pérez-Calderón (검색결과 1 건)
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        Toxic Epidermal Necrolysis in Polymedicated Patient Treated With Radiotherapy

        Remedios Pérez-Calderón,M. Angeles Gonzalo-Garijo,Silvia Corrales-Vargas,Gloria Jiménez-Ferrera,Isabel Rodríguez-Nevado,Mario Díaz-Delgado 대한천식알레르기학회 2015 Allergy, Asthma & Immunology Research Vol.7 No.2

        Temozolomide is an oral alkylating agent indicated for the treatment of patients with glioblastoma multiforme concomitantly with radiotherapy andsubsequently as monotherapy treatment. We report the case of a patient who developed toxic epidermal necrolysis (TEN) while she was beingtreated with chemoradiotherapy and several drugs. Cutaneous tests were performed with the drugs involved with negative result. Although the occurrenceof TEN contraindicates suspected drug readministration, we based the decision to perform the controlled administration of temozolomideon the following reasons: (1) the poor prognosis of the underlying disease, (2) the lack of therapeutic alternatives, (3) the suspicion that other drugstaken by the patient simultaneously may be responsible (as anticonvulsants and trimethoprim sulfamethoxazole [TMP-SMX]), and (4) temozolomidewas the first choice for treating the patient’s disease. The administration of a cumulative dose of 60 mg of temozolomide caused a slight skin reaction. Given this result, we conducted controlled administration of other drugs involved. Dexamethasone, codeine, omeprazole and levetiracetamwere well tolerated. However, TMP-SMX produced a similar reaction to that caused by temozolomide. In conclusion, we present the first case ofTEN induced by temozolomide and TMP-SMX associated with cranial radiotherapy confirmed by controlled administration. Radiotherapy in combinationwith these drugs could have favored TEN, as some authors have postulated, but we cannot prove this.

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