習慣性顎関節脱臼および薬物過敏反応を呈したEhlers-Danlos症候群の1例

抄録

A 24-year-old woman complaining of a toothache was referred to our department in February 1999. She had a long history of hypersensitive reactions to drugs, recurrent dislocation of the shoulder joints, and hyperthyroidism. She underwent allergy testing for local anesthetics at the second department of anesthesiology of our university. Shortly after the test, she fell into respiratory insufficiency, lost consciousness, and was transferred to the intensive care unit. After a week she was discharged. Further examinations for drug allergy at the department of dermatology of our university revealed that she was not allergic to diclofenac sodium or mepivacaine hydrochloride. We speculated that the allergic reactions may have been psychogenic. At the same time, Ehlers-Danlos syndrome was diagnosed. After successful dental treatment, both temporomandibular joints were dislocated while eating. Repositioning was possible under local anesthesia with mepivacain hydrochloride. Subsequently, temporomandibular joint dislocation has occurred several times. The joint has usually been repositioned by a physician, with the patient under local anesthesia. However, the patient has sometimes successfully done repositioning by herself.