Drug Hypersensitivity Reactions: Pathomechanism and Clinical Symptoms

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6 650 P v w v I v w y M I y z M, M w T M I yvy w x z ; wy LAB*5701 y y v, w v v yvy Sy,, LA B*1502 y y SvJ y (SJS/ x y (TE z B, 2 y y I M I yvy, y M I, qy (D81 T W y M I, w M, v, M ( x xy w M I ( F 1, M y (vy x 26 Avy, y D41 T w y w TR F D4 w q w M II ; wv, y j y M, v M II, v T T, D4, M v y y (y x, y w y y [DRESS] S w: Pv k, kw I vy, w z 7 I, y y w y T Gz w F T yvy ( w 7,27 F v (? I T w v/ SJS/TE DRESS/ yvy y (DS (? T w wy x yvy I yv, y w w w T vy y T v j, w y wy R y y v y B z I y B z

7 D yvy R 651 LASSIFIATI F DRUG YPERSESITIVITY REATIS G 28 yvy, w, 4 y IIV : T IE y IE ky, x, T B v T, w y y, G 28 7 IV, IV, IV, IV, y T T x G 28 x v vv T y, v, y v, y y : x, yx, y y IE T wv, IE v v I w x, y k y, v y yx T y v F y, k v y Ty I (IE A T IE y I v vy y q w y yz IE (FIE RI, w IE k FIE RI, v (, y, k,, TF,, w y y IE v y v / x: B, v I w x, IE T y x T, w w B (, v D40D40L w IL4/IL13, w w IE y T z y y w w, x, w k IE y (F 2 P IE IE v : 1 Vy w k IE Ev (ID k w y y, ID v 29 W? Wy y v? T y k 2 j IE, vy k IE FIE ( F 2 I v, 2 IE ( k 2

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9 D yvy R 653 yx w x q wy Sw 34 P w wy, Sw P IE, w w y qy MBA 35 T, wy y w y z v v 34 T w y IE /MBA/qy, y MBA 3 Ay w, vy v wv, wv, IE y F, z, w v 36 IE IE v, v, : z v, w w y, k Sy y w,,, x, T y, y v, y, v y w (F 3 T y y z, w xy 10 20, z y v T x Ly w y / y k ww, w y y; P w M v x yx, 37, w yx, y v w ( v, w z,, Ay k w 10 15, yx y w Ayx y 60% yx 38 S v y (,, v, T y v v xv v y, w T y y k, w xy 1% 2% yx T y, ky Rk v, x (,, y, yx, y v P w y v (,,, y y v y A w vv, v yx y y y y 1 y (, v y w y; k y y v Ayx v v, vv v v T 1 z yx M IE v, y,, w y v wv, y IE y y, y w, IE

10 654 P F 3 Ayx Ayx x v I, v v Sy (,, I y,,, v y vv, v yv, v v xv (, y T v y k, w 1% 2% ( x (F P WJ D yvy: T v I: P WJ, D yvy B (Swz: K; ; w PSEUDALLERGY ( IMMUEMEDIATED YPERSESITIVITY S ( yv, w q IE, y y M, IE (y,, yx D v SAID y ( >15 k IE, y y q IE I y v ( T 1 P y y, ( T 1 S, y, v k k

11 D yvy R 655 T 1 T yx D Ivv IE A F ( I (IE IA L P Pyz Q MBA D P R (R P x SAID: yy,,, Vy Pyz Q MBA ; y T v yx MBA, w y (y v x Sk y v v w v 32 S w v v k 33 (, MBA I v, y S w y wy (, y v, y y, w y IE T v,, v v, w k A y v y v A w y v y y v, wk v y S y w, w w v v, 39 T SAID ( y M SzB w x IGGMEDIATED REATIS (YTTXI MEAISM AD IMMUE MPLEX DEPSITI, TYPES II AD III Ty II y III y x IG (IG1, IG3 IM y vv Ty, x w FIG (FIGI, II, III (, k [K], y,, y q I y II, q A yy, ky,, y w T y w q y v y F M y, v y y y

12 656 P y vv,, v, y, q, y y T y y y y j w k y v ( Ty, w q, q, I w (y D y y v 5 8 y x z, x vy x P w w w k, y y I A vk, y w 3 5 y (S y T Sz w x F x v y y I wy,, x v: Vy x v; v y, w y x; FIGR 40 T, v x y x y, y (PM, x FIGR PM I, yx 3 5, v, y PM A y III y v v k: I k, w 4 10 y (1q x y v ky y w FIGRIII, 41 w y y zy ( k yvy v y y M, w y SMX, x, x, SAID, B x, x, z v y w k 42 ( y w x V y z, y k, ;, y I, Sö, w T w vv y v IA x, y ky IA y, (F 4 TELL MEDIATED, DELAYED DRUG YPERSESITIVITY REATIS S Ty IV R T y T 30 y v T y j : T, w B y ; T, w

13 D yvy R 657 F 4 Rv G D y A T, y y (y I III T/yk (y IV IV 7 Ty I IE k IE y IE (FIE RI ky, w vy y (v, y,,, Ty II IG, v w FIG k Ty III IG : v v y v FIG v Ty IV T1 w IF/TF, vv y/ v D8 (y IV Ty IV T2 w IL4/IL5/IL13 ; y w IE y I Ty IV : yx (y D4 D8 y yx T (y IV Ty y yvy Ty IV T, y I x y (PM I XL8/GMSF y T ( (F P WJ D yvy: T v I: P WJ, D yvy B (Swz: K; ; w ; T yxy B, w v vv, T y IV w v I yk y T,

14 658 P w T1/T2 T ; yx vy D4 D8 T (IV; z y (IV, (IV, (IV, w 7 Ty IV T1y : T1y T v y, v x y y vv y II III (IG1, IG3, y y (, IL12 D81 T T T y IF y yk (, TF, IL18 A vv w y v (, k v,, T1 kw v D8, w x IV IV (, Ty IV T2y T2 T yk IL4, IL13 IL5, w B IE IG4, v, : T T2 yk IL5, w y y y yvy 7 I, k y I, T2 IE y IL4/IL13 A vv x w, ( I y IV, T v Ty k y ky / zyb, y, FL (F 5 27,43,44 S y yvy, y w y IV (y,, PM v yx T y k (w y w (, z x [AGEP], Ty IV k, w v D81 T k ky, 7,43,44 y y y 27 Ty IV vv w T ( 45 Ty x w k, AGEP I, XL8 y y (GMSF T ky v XL8, v v GMSF 46 I AGEP, T Bç 47 T w x yk IL17, w, vv y T M M k w v I k w wv, y, 7 qy z, 48 2% 4%, 30% 50% y v y w SMX, k, y (v y

15 D yvy R 659 M yvy A y I y x y x Sk LTT ++ x y I B F y x y Sk LTT ++ x y ++ vy x x y Sk LTT ++ x x F 5 T yv,, v I yv : (A 2 y y T z y y T yvy (B v y: x y k :, yvy,, y v x y T y, y ( wy ( Sy y vy T y (F P WJ D yvy: T v I: P WJ, D yvy B (Swz: K; ; w T y y Ty y v A, y y w : DRESS SJS/TE, T w v: y w x DRESS,,, w

16 660 P y 49 I, T TE w vy F wk, qy v yvy y DRESS y x y T T 1 I: v, (y, wk 2 Lk v: x y y, w y v y,, TR y yk, T y v 3 Ry T y y v, k T y v y y 4 T v : v v y, w v v y Sy T R T q y ; R y w 6 10 y k T k yvy, v vv v v zy (y x, y ky,, y vv (F y y S w x M yvy y T yvy wy v : z w (y v, y SAID, ; v w y 50 vy y I x, 10% w w yvy (v k yy v 51 : y y v j w v ; y v y B v k yy Avy, x, y, SMX w w, w y ( x [MPE], yvy y [DS]/DRESS, y M w yvy v v 1 A IE w y T T y kw, F P WJ D yvy: T v I: P WJ, D yvy B (Swz: K; ; w

17 D yvy R 661 ( F 5 A, v,, y v y 49 Py v y k v y yvy 33 M yvy vy ( F 5 F y q: w y w v v y, 52 v T v y k x k ( F w, x y, y w : y x x y ( y x, [ALAT], v 1 2 y, w w y S v DS/DRESS ( W x, 27 y y T, y x : y v w,, y v T, y y wv,,, y, y x wv, z, w DRESS/DS SUMMARY S w y 2 wy: y x, w v y (T B z y x; vy, v y w y v W S w ( w, B y TR w M, T T y y y w M I w TR F v v T wy q TR w M T q, w w Ty y y IE y Dy 6 ; v y y Dy y x, w w vv, w T yk y T y IV y IV, IV, IV, IV, T w y/d (IV, (IV, yx T (IV, (IV v

18 662 P REFEREES 1 DJ, G SF, P M, I v : y D S 2000;23: Lz J, Pz B, y P I v z : y v JAMA 1998;279: Rj J, S RS Sv v E J M 1994;331: By M, Jk S, Jk, D A B v D Sv P 15,438 v, JAMA 1986;256: zk T, Kz UP, Bw S, v (DM: v k, 20y vy Ay 1997;52: M M, Sv M, T S, D IE q J Ay I 2004;113: P WJ D yvy: T v I: P WJ, D yvy B (Swz: K; G P, Wk M, S B, A x: w y? I Ty 1998;19: S JP, DJ, F J, Sxz xz y J I 2007;178: Sy B, Mw D, Z M, D, M xz T J Iv 1997;100: Z MP, v Gyz S, Sy B, LA, wy y T yy J Iv 1998;102: P WJ P w : Ay I 2002;2: P WJ D T y y y Txy 2005;209: S S, Kwk Y, A M T, Dyy yvy y y 2 wy y T J Ay I 2002;109: DJ, B M, W G, yvy z: z y, y, yk T M P 2003;63: W Y, F J, P M, G z D41, D81, D41D81 T w z yvy J Ay I 2007;119: K M, L M, B M, P wy y T Ex Ay 2010;40(2:257 68

19 D yvy R Bk, B M, S I, v xz D41 T y Ex Ay 2002;32: v Gyz S, B G, Sy K, Dy vy (1 T I I 2001; 13: Tyk W, J T, P, S w LAB*5801 SvJ y x y T P G 2009;19: M B, Kw P, B L, A w LAB*1502 E 2007;48: S, AR, M M, G v LAB yvy v L 2002;359: M S, D, W, A w LAB*5701, LADR7, LADQ3 yvy IV1 v v L 2002;359: D, Kk L, L T, ky I v D81 T v y yvy Iy 2008;28: Y L, J, L v v PLS B 2009;5: Y W, SI, J G, LAB*1502 : z SvJ y J Ay I 2007;120: Mk M, Zwk A, K M, F v vy z DRESS y: v A J T 2009;9: PR, G PG yvy I: G RR, y x (UK: x Uvy P; Rzz I, B S, M, x y k: Ay 2010;65: L, J, L G, Sv IE J Ay I 2008;122: Py R Ayx: w w k? Ay I 2004;4: M PM, L M, GRz RM, Pv yx I Ay A 2009;29: Bkw K, R A, A W, Sk w yvy E y Ay 2009;64: Fv E, J SG T y I Ay A 2009;29: B BA, F MM, P y k ( x : v Ex Ay 2009;39:325 44

20 664 P 36 M R z yvy I Ay A 2009;29: S A, MzF A, RL, S y yx: y S I Ay I D/F Ay Ayx wk y J Ay I 2006;117: Py RS F yx UK, v F Sy 2004;257: [: 28 32, 57 60, ] 39 T MR, v E E, Ly P, P v y : y vw BMJ 2006;333: A TJ, D R, Vy TJ, y y F3 2006;439: Sk T, D P, X L, 1q v x ky F q J Ex M 2004;200: P WJ Av Ay 2006;61: A, B A, D G, D yx T k w x y J Iv D 2002;118: Sy B, F K, Mw D, T yxy ky xz k Ex Ay 1998;28: B M, S U, S S, T vv z x J Iv 2001;107: S P, B M, K M, z T k J I 2004;173: K M, S Z, S P, T y J I 2005;175: B A, E, G B, L vy qy T v y yvy J Ay I 2006;117: Tk R, K Y, Yzk Y, Dv y T w v : y w y J I 2009;182: Sv T S y y J Ay I 1989;83: Gx, A, P WJ M yvy yvy y yy J Iv A I 2005;15: Y, FSy K, M, T vv Ex Ay 2001;31:

Auburn University Style Guide & Identification Standards Manual

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