内容紹介
Summary
A 48-year-old woman with advanced gastric cancer with peritoneal dissemination was treated with weekly paclitaxel from October 2015 and was then administered the CapeOX regimen. Although she had no adverse event during the 2-hour administration of the first oxaliplatin(L-OHP), sudden wheezing, subsequent decrease in blood pressure, and vomiting occurred after completing the administration. After intravenous injection of epinephrine(1 mg)and drip infusion of methylprednisolone(500 mg), she received continuous administration of norepinephrine for 5 days. Hypersensitivity reaction to L-OHP typically occurs after several cycles and within 30 minutes of starting the administration. However, we have to recognize that the hypersensitivity can also occur after the first cycle and at a later onset.
要旨
症例は48歳,女性。胃癌腹膜播種のため,2015年10月よりweekly paclitaxelを開始した。画像上SDであったが経口摂取が安定したため,2016年1月よりCapeOX療法へと変更した。1サイクル目のoxaliplatin(L-OHP)投与中には有害事象を認めなかったが,投与終了後(投与開始から2時間後)に急に喘鳴が出現しshock vitalとなった。methylprednisolone 500 mg点滴,epinephrine 1 mg静注,入院後の保存的加療などにて徐々に症状は改善した。L-OHPのアレルギー反応は6サイクル前後・投与開始後30分以内に認めることが多いが,自験例のように1サイクル目・2時間経過後に発症するタイプもあることを念頭に置く必要がある。
目次
A 48-year-old woman with advanced gastric cancer with peritoneal dissemination was treated with weekly paclitaxel from October 2015 and was then administered the CapeOX regimen. Although she had no adverse event during the 2-hour administration of the first oxaliplatin(L-OHP), sudden wheezing, subsequent decrease in blood pressure, and vomiting occurred after completing the administration. After intravenous injection of epinephrine(1 mg)and drip infusion of methylprednisolone(500 mg), she received continuous administration of norepinephrine for 5 days. Hypersensitivity reaction to L-OHP typically occurs after several cycles and within 30 minutes of starting the administration. However, we have to recognize that the hypersensitivity can also occur after the first cycle and at a later onset.
要旨
症例は48歳,女性。胃癌腹膜播種のため,2015年10月よりweekly paclitaxelを開始した。画像上SDであったが経口摂取が安定したため,2016年1月よりCapeOX療法へと変更した。1サイクル目のoxaliplatin(L-OHP)投与中には有害事象を認めなかったが,投与終了後(投与開始から2時間後)に急に喘鳴が出現しshock vitalとなった。methylprednisolone 500 mg点滴,epinephrine 1 mg静注,入院後の保存的加療などにて徐々に症状は改善した。L-OHPのアレルギー反応は6サイクル前後・投与開始後30分以内に認めることが多いが,自験例のように1サイクル目・2時間経過後に発症するタイプもあることを念頭に置く必要がある。