[1例因环丝氨酸出现精神不良反应的耐多药结核病病例]

[A case of multi-drug resistant tuberculosis showing psychiatric adverse effect by cycloserine].

作者信息

Fujita Junichi, Sunada Kouichi, Hayashi Hiroki, Hayashihara Kenji, Saito Takefumi

机构信息

Department of Respiratory Medicine, Tsukuba Gakuen Hospital, 2573-1, Kamiyokoba, Tsukuba-shi, Ibaraki 305-0854, Japan.

出版信息

Kekkaku. 2008 Jan;83(1):21-5.

PMID:18283911

Abstract

A 45-year-old man with multi-drug resistant tuberculosis were referred to our hospital for treatment. We started chemotherapy with cycloserine (CS), ethionamide (TH), kanamycin (KM), pyrazinamide (PZA), para-aminosalicylic acid (PAS) and gatifloxacin (GFLX). Two months later, psychosis and seizure occurred and worsened day after day. We suspected that these symptoms were due to CS. After stopping CS, psychosis and seizure disappeared. After surgical operation, positive tubercle bacilli in sputum converted to negative both on smear and culture. He was successfully discharged from our hospital. We should take care on side effects with second-line drugs that are often used in treating multi-drug resistant tuberculosis.

摘要

一名45岁的耐多药结核病男性患者被转诊至我院接受治疗。我们开始使用环丝氨酸（CS）、乙硫异烟胺（TH）、卡那霉素（KM）、吡嗪酰胺（PZA）、对氨基水杨酸（PAS）和加替沙星（GFLX）进行化疗。两个月后，出现了精神病症状和癫痫发作，且症状日益加重。我们怀疑这些症状是由CS引起的。停用CS后，精神病症状和癫痫发作消失。手术后，痰中的结核杆菌涂片和培养结果均转为阴性。他成功从我院出院。我们在治疗耐多药结核病常用的二线药物的副作用方面应予以关注。