テオフィリン投与中の痙攣症例に関する臨床的検討 : 第III報 後遺症・死亡症例からみたテオフィリンの安全性に関する検討  [in Japanese] A CLINICAL REVIEW OF PATIENTS WITH SEIZURES THAT DEVELOPED DURING THEOPHYLLINE ADMINISTRATION : (III) SAFETY OF THEOPHYLLINE EXAMINED IN PATIENTS WHO HAD SEQUELAE OR DIED  [in Japanese]

【目的】テオフィリン投与中に発症した痙攣に引き続き後遺症・死亡に至った症例の原因を検討した.【方法】第1報で検討した334例より痙攣発症後に後遺症・死亡に至った56例を抽出し,これらの症例が後遺症・死亡に至った要因を検討した.【結果】痙攣発症時に発熱していた症例が多いこと,痙攣発症前に神経学的素因を有していることがわかっていた症例が多いこと,発熱及び神経学的素因ともに有していない症例は1例のみであることがわかった.これらの症例の多くは,痙攣発症時のテオフィリン血中濃度が目標の範囲内(5〜15μg/mL)またはそれを下回る濃度であった.【結語】テオフィリン投与中に発症した痙攣に続く後遺症・死亡を避けるためには,発熱及び神経学的素因の存在に注意する必要があると推察された.

Objective: To examine the causes of sequelae or death of patients who presented them subsequently to seizures that developed during theophylline administration. Methods: Among 334 patients who had been examined in Study (I), we wxtracted 56 who had sequelae or died subsequently to the onset of seizures and examined their causes. Results: Many patients had fever at the onset of seizures, many patients had neurologic predispositions prior to seizure onset, and only one patient was found to be free from fever and neurologic findings. At the onset of seizures, most of these patients had blood theophylline concentrations that were within or inferior to the target range (5-15μg/mL). Conclusions: We presume it necessary to pay heed to fever and neurologic predispositions in order to prevent sequelae or death that may occur subsequently to seizures that developed during theophylline administration.