恩格列净致皮肤过敏反应  

Skin allergic reaction induced by empagliflozin

作　　者：刘永红 陈晓平[2] 帅瑛[2] Liu Yonghong;Chen Xiaoping;Shuai Ying(Department of Endocrinology,Shanxi Jiaocheng County Medical Group People′s Hospital,Shanxi Province,Jiaocheng 030500;Department of Endocrinology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]山西省交城县医疗集团人民医院内分泌科,交城030500 [2]中日友好医院内分泌科,北京100029

出　　处：《药物不良反应杂志》2021年第9期493-494,共2页Adverse Drug Reactions Journal

摘　　要：1例68岁男性2型糖尿病患者应用沙格列汀、二甲双胍和伏格列波糖治疗10个月,因血糖抑制不佳,将伏格列波糖换为阿卡波糖,2 d后又换为恩格列净(10 mg口服、1次/d)。次日应用复方托吡卡胺滴眼液散瞳,3 h后(第2次服用恩格列净4 h后),患者胸腹部出现散在红色风团样皮疹伴瘙痒,继之眼睑水肿。考虑复方托吡卡胺滴眼液过敏,予氯雷他定和西替利嗪,皮疹逐渐消退,但皮肤瘙痒加重,且躯干、上肢逐渐出现弥漫性红色斑丘疹,压之褪色。皮肤科医师会诊后考虑为恩格列净引起的过敏性皮炎,停用恩格列净,加用非索非那定和炉甘石洗剂,皮疹消退。因患者病情需要,3 d后再次使用恩格列净,用药9 d后患者再次出现皮肤过敏反应,停用恩格列净,经抗过敏治疗后皮疹未再出现。考虑患者的皮肤过敏反应与恩格列净相关可能性大。A 68-year-old male patient with type 2 diabetes mellitus received saxagliptin,metformin,and voglibose for 10 months,voglibose was switched to acarbose due to poor blood glucose control firstly and then to empagliflozin(oral 10 mg thrice daily)2 days later.Next day,compound tropicamide eye drops was used to mydriasis and 3 hours later(2 hours after the second administration of empagliflozin),the patient developed scattered red wheal like rash with pruritus on the chest and abdomen,followed by eyelid edema.Considering allergy to compound tropicamide eye drops,loratadine and cetirizine were given,the rash gradually subsided,but the skin pruritus increased.Diffuse red macules and papules,which faded from pressure,gradually appeared on his trunk and upper limbs.Allergic dermatitis caused by empagliflozin was considered after consulting the dermatologist,empagliflozin was discontinued,fexofenadine and calamine lotion were added,and the rash subsided.Due to the patient′s condition,empagliflozin was readministered 3 days later,and the patient experienced a skin allergic reaction again 9 days after the treatment.Empagliflozin was stopped again and the rash did not recur after anti-allergic treatment.It was considered that the patient′s skin allergic reaction was possibly related to empagliflozin.

关 键 词：钠-葡萄糖转运蛋白2抑制剂 过敏反应 药疹 恩格列净 

分 类 号：R969.3[医药卫生—药理学]