药物超敏反应综合征患者巨细胞病毒抗体转阴后可疑致敏药物斑贴与激发试验  

Oral Irritating and Patch Tests to Suspected Allergic Drugs in A Patient with Drug Induced Hypersensitivity Syndrome after Cytomegalovirus IgG Becoming Negative

作　　者：王松[1] 许爱娥[1] 郑捷[2] 李霞[2] 

机构地区：[1]杭州市第三人民医院皮肤科,杭州310009 [2]上海交通大学医学院附属瑞金医院皮肤科,上海200025

出　　处：《中华临床免疫和变态反应杂志》2014年第2期134-137,共4页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的对药物超敏综合征(drug induced hypersensitivity syndrome,DIHS)患者临床症状消失、巨细胞病毒抗体转阴后进行可疑致敏药物的皮肤斑贴试验与口服激发试验,为了解病毒感染在DIHS中的发病机制提供依据。方法 1例可疑致敏药物为美西律和头孢呋辛的DIHS患者临床痊愈2年后行皮肤斑贴试验,分别于48、72和120 h连续观察,均未出现皮疹为阴性;另外,行口服激发试验,服药期间和停药1周内未出现发疹和发热为阴性。结果斑贴试验阴性,口服激发试验后随访20个月未有发热、发疹。结论 DIHS是由病毒感染参与、T淋巴细胞介导的迟发型超敏反应,病毒感染是导致该型药疹发生的"共因子"。The patch test and oral irritating test of suspected allergic drugs were investigated in a patient with drug rash with eosinophitia and systemic symptoms （DRESS）also known as drug induced hypersensitivity syndrome （DIHS ） after clinical recovery and CMV IgG showing negative so that the mechanism of DRESS could be known much.Methods Patch tests were made with suspected allergic drugs mexiletine and cefuroxime.The results were observed after 48,72 and 1 20 hours continuously.Oral irritating tests were made after the negative result of patch test.Results Patch tests of the both suspected allergic drugs were negative,and the oral irritating tests were also negative because the patient were neither fever nor eruption 20 months later.Conclusions DRESS is a delayed hypersensitivity reaction mediated by T lymphocyte,in which virus infection is the cofactor of its onset.

关 键 词：药物超敏综合征 巨细胞病毒 斑贴实验 激发实验 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]