局所麻酔薬による遅延型アレルギーの一例

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  • A case suspected of delayed type allergy to local anesthetics

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The allergic reactions to drugs are divided into two types ; type I (anaphylactic or fast type) and type IV (delayed type). The anaphylactic type is due to the specific IgE antibody and the reactions occur immediately after the administration of the causal drugs. On the other hand, the delayed type is due to the specific T cell and the reactions are more slowly. We experienced a case who suffered from delayed type allergic reaction twice after dental treatment. At the first time, the patient’s lower firstmolar was extracted under local anesthesia with 3% prilocaine with felypressin and he had acetaminophen for the postoperative pain. At second time, scaling was done under surface anesthesia with COPARON which contains 6% tetracaine hydrochloride. We performed the drug−induced lymphocyte stimulation test ; DLST and the challenge test. It was ascertained from the anamnesis and the results of allergic tests that the causal drugs for the allergic reactions were 3% prilocaine with felypressin and COPARON . 2%lidocaine for surface anesthesia, 2% lidocaine with adrenaline, acetaminophen and cefdinir were safely used.

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  • 松本歯学

    松本歯学 39 (1), 12-15, 2013-06-30

    松本歯科大学学会

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