因Diclofenac使用牽涉多種器官系統的過敏性血管炎病例報告

Hypersensitivity Vasculitis after Taking Diclofenac Sodium with Multiple Organs Involvement-- A Case Report

一位四十九歲男性，在服用diclofenac sodium之後，被診斷為過敏性血管炎。病症表現為休克及多種器官受損包括皮膚、肌肉、肺臟、心臟、腎臟及神經系統。實驗室檢查顯示免疫複合體升高與補體低下。此外，有高力價的抗中性球細胞質抗體(ANCA)可偵測到。腎臟切片顯示間質性腎炎與肉芽腫反應。雖然病人對類固醇反應良好，但褥瘡感染之抗藥葡萄球菌終致死亡。過敏性血管炎通常為一過性，偶也會造成多種器官受損而導致死亡，臨床用藥須小心。

A 49 y/o man was diagnosed to have hypersensitivity vasculitis after taking diclofenac sodium. Shock with multiple organs involvement including hypersensitivity vasculitis in the skin, showed elevated levels of immune complex and hypocomplementemia. In addition, strong titers of anti-neutrophil cytoplasmic antibody was found. Interstitial nephritis with granulomatous reaction were diagnosed by renal biopsy. Although the patient was responsive to steroid therapy, refractory staphylococcal infection from the bed sore leaded to death finally.