Toxic epidermal necrolysis after dactinomycin and vincristine combination chemotherapy for nephroblastoma  

肾母细胞瘤更生霉素和长春新碱联合化疗并发中毒性表皮坏死松解症的报道（英文）

作　　者：Yuan LIANG Zhou YANG Zi-gang XU Lin MA 

机构地区：[1]Department of Dermatology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China

出　　处：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》2017年第7期649-652,共4页浙江大学学报（英文版）B辑（生物医学与生物技术）

基　　金：Project supported by the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding(No.ZYLX201601);the Project of Excellent Talents in Beijing City(No.2013A003034000013);the National Natural Science Foundation of China(No.81602754)

摘　　要：In this study, we describe a 2-year-old boy patient with nephroblastoma who has developed toxic epidermal necrolysis （TEN） associated with the combination chemotherapy administration of dactinomycin and vincristine. A skin biopsy confirmed the diagnosis of TEN, and with methylprednisolone pulse therapy, intravenous immunoglobulin （WIG）, and supportive care, the patient improved significantly.中毒性表皮坏死松解症是一类临床罕见但严重威胁患者生命的重症药疹,死亡率高达30%~50%。儿童中最常见致敏药物为抗癫痫药、抗生素和解热镇痛药。化疗药物引发中毒性表皮坏死松解症报道少见。本文报道一例2岁肾母细胞瘤患儿经更生霉素联合长春新碱化疗1周后并发严重皮肤药物不良反应——中毒性表皮坏死松解症。本报道旨在提醒肿瘤科医生警惕肿瘤患者治疗过程中发生中毒性表皮坏死松解症这一高致死性重症药疹的可能,需要在临床中密切观察患儿皮肤表现,一旦出现相应症状须立即作为危重症处理;同时提示皮肤科医生警惕化疗药更生霉素有引发中毒性表皮坏死松解症的可能,发现此类病人用药时出现皮疹应重视。早期识别并停用可疑药物,联合积极支持治疗可显著改善患者预后,降低死亡率。

关 键 词：药疹 恶性肿瘤 中毒性表皮坏死松解症 化疗 肾母细胞瘤 

分 类 号：R737.11[医药卫生—肿瘤] R758.25[医药卫生—临床医学]