Charii Hajar, Tahri Samah, Boudouh Asmae, Kouismi Hatim, Bourkadi Jamal-Eddine
Department of Pulmonology, Mohammed VI University Hospital, Oujda, MAR.
Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR.
Cureus. 2023 May 11;15(5):e38862. doi: 10.7759/cureus.38862. eCollection 2023 May.
Tuberculosis (TB) is still a major public health concern in Morocco. Although first-line antituberculosis drugs (ATD) are generally considered safe and effective, serious adverse events can occur. In this case report, we describe a female with pulmonary TB who experienced anaphylaxis induced by rifampicin (RFP) and pyrazinamide (PZA) during ATD therapy. Anaphylactic reactions to first-line ATD can occur and may lead to treatment discontinuation and challenges in finding effective alternative treatment options. Healthcare professionals should be aware of the potential of anaphylaxis with the use of these drugs, especially in patients with a history of lupus. Further research is needed to better understand the mechanisms underlying anaphylaxis and develop effective preventive and management strategies. A young female patient with a history of lupus and splenectomy presented with respiratory symptoms and deterioration of general condition. She was diagnosed with pulmonary tuberculosis and received first-line ATD, which caused complications including liver dysfunction and anaphylactic shock. Despite these challenges, the anaphylactic shock was successfully managed; she was put on a combination of levofloxacin, kanamycin, and ethambutol (ETB), as well as a desensitization protocol for isoniazid (INH); the patient was cured.
结核病（TB）在摩洛哥仍然是一个主要的公共卫生问题。尽管一线抗结核药物（ATD）通常被认为是安全有效的，但仍可能发生严重的不良事件。在本病例报告中，我们描述了一名患有肺结核的女性，她在接受抗结核药物治疗期间发生了由利福平（RFP）和吡嗪酰胺（PZA）引起的过敏反应。对一线抗结核药物的过敏反应可能会发生，并可能导致治疗中断以及寻找有效的替代治疗方案方面的挑战。医护人员应意识到使用这些药物时发生过敏反应的可能性，尤其是在有狼疮病史的患者中。需要进一步研究以更好地了解过敏反应的潜在机制，并制定有效的预防和管理策略。一名有狼疮和脾切除病史的年轻女性患者出现呼吸道症状和全身状况恶化。她被诊断为肺结核并接受了一线抗结核药物治疗，这导致了包括肝功能障碍和过敏性休克在内的并发症。尽管面临这些挑战，过敏性休克仍得到了成功处理；她开始使用左氧氟沙星、卡那霉素和乙胺丁醇（ETB）联合治疗，以及对异烟肼（INH）的脱敏方案；患者最终治愈。
