药物超敏综合征1例并文献回顾  

One case of drug hypersensitivity syndrome and literature review

作　　者：齐婧 解方[1] 郝甜[1] 李承新[1] QI Jing;XIE Fang;HAO Tian;LI Cheng-xin(Department of Dermatology, General Hospital of PLA, Beijing 100853, China)

机构地区：[1]中国人民解放军总医院皮肤科,北京100853

出　　处：《中国药物应用与监测》2019年第1期50-53,共4页Chinese Journal of Drug Application and Monitoring

基　　金：解放军总医院科技创新苗圃基金项目(14KMM04)

摘　　要：1例18岁男性患者,全身红斑丘疹瘙痒伴发热5 d,发病前有明确用药史,实验室检查示:白细胞30.84×109·L^(-1),嗜酸性粒细胞直接计数1.79×109·L^(-1),异型淋巴细胞4%,ALT 300 U·L^(-1),AST 150 U·L^(-1),ALP 320 U·L^(-1),γ-GGT 330 U·L^(-1),初步诊断为药疹,给予甲泼尼龙(80 mg,qd,ivgtt),5 d后患者病情缓解,故给予减少甲泼尼龙用量(40 mg,qd,ivgtt)。减药后2 d患者复查白细胞31.46×109·L^(-1),嗜酸性粒细胞直接计数4.44×109·L^(-1),异型淋巴细胞7%,单纯疱疹病毒IgM抗体(+),临床诊断为药物超敏综合征,加用人免疫球蛋白(30 g,qd,ivgtt)和注射用膦甲酸钠注射液(2.4 g,tid,ivgtt)治疗,患者病情好转。出院后随访24个月,患者皮疹无复发。One 18-year-old male patient had a large area of erythematous papules with itching and fever for 5 days. There was a clear history of medication before the onset. Laboratory tests showed that leukocyte 30.84 × 109·L^-1, eosinophil direct count 1.79 × 109·L^-1, atypical lymphocyte 4%, ALT 300 U·L^-1, AST 150 U·L^-1, ALP 320 U·L^-1,γ-GGT 330 U·L^-1. The initial diagnosis was drug eruption, and the patient was administered methylprednisolone (80 mg, qd, ivgtt). Five days later, the patient got better, so the dose of methylprednisolone was reduced (40 mg, qd, ivgtt). Two days later, the patient's rash and fever reappeared. Laboratory tests showed that: leukocyte 31.46 × 10^9·L^-1, eosinophil direct count 4.44 × 109·L^-1, atypical lymphocyte 7%, herpes simplex virus IgM (+). Then the patient was diagnosed as drug-induced hypersensitivity syndrome. After treated with human immunoglobulin (30 g, qd, ivgtt) and antiviral drug (foscarnet sodium 2.4 g, tid, ivgtt), the patient's condition improved. During the followed-up period of 24 months after discharge, there was no rash recurred.

关 键 词：药物超敏综合征 嗜酸性粒细胞增多 药疹 疱疹病毒 

分 类 号：R969.3[医药卫生—药理学]