Language：Japanese   Publisher：(公社)日本小児科学会  

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Language：English  

The most common cause of erythema multiforme (EM) in children is infectious diseases which account for approximately 90% of cases. Drug eruptions are another common cause. Here we are reporting about a male patient aged 14 years with lymphadenitis who developed severe diffuse erythema during the course of treatment with medications including several antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs). Based on the pathological findings of the skin biopsy, the skin rash was due to EM. Upon investigating the underlying cause of EM, viral antibody was positive for Coxsackie A6, lymphocyte transformation testing (LTT) was positive for one of the NSAIDs, and the patch test (PT) was positive for amoxicillin. Based on the pattern of distribution of the skin rash, the cause of EM was considered to be drug-induced eruption due to amoxicillin. In this case, we did not derive a diagnosis of drug eruption without investigating the possibility of drug induction, because most cases of EM in children are induced by infection and the antibody against Coxsackie A6 was elevated. To diagnose the possibility of amoxicillin-induced EM, it was important to distinguish between the distribution patterns of infectious versus drug-induced EM and to evaluate the possibility of drug induction by both LTT and PT. If the diagnosis of amoxicillin-induced EM, had not been made, the potential recurrence of EM with amoxicillin could have occurred.

DOI： 10.5415/apallergy.0000000000000108

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/ped.15681

PubMed

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Language：Japanese   Publisher：(一社)日本小児感染症学会  

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Language：Japanese   Publisher：沖縄県医師会医学会  

10歳男児。肉眼的血尿、嘔吐、活気低下、眼瞼浮腫を主訴に前医を受診した。前医では急性糸球体腎炎の診断で入院し、フロセミドの投与が行われるも腹痛が出現し、腎機能の増悪を認めたため当院へ転院となった。入院後、尿毒症症状や腎機能の増悪を認め、血液透析にて症状や臨床検査値は改善し、入院13日目に自宅退院となった。尚、原疾患に関しては先行感染の存在、特異的治療の未施行にも関わらず腎機能と尿所見の速やかで著明な改善、8週以内の補体の正常化、ASO高値、抗核抗体・抗ds-DNA抗体が陰性であることから、溶連菌感染後急性糸球体腎炎(PSAGN)と診断された。過去5年間のPSAGN入院患者10名を検討すると、透析導入に至ったのは本症例のみであり、入院時に透析導入を予見する有用な所見は不明であった。

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Language：Japanese   Publisher：(公社)日本小児科学会  

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Language：Japanese   Publisher：(公社)日本小児科学会  

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Language：Japanese   Publisher：(公社)日本小児科学会  

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Language：Japanese   Publisher：(公社)日本小児保健協会  

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Language：Japanese   Publisher：(公社)日本小児科学会  

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