奥希替尼致中毒性表皮坏死松解症一例并文献复习  

Toxic epidermal necrolysis caused by osimertinib and literature review

作　　者：朱莉 赵晴 王娜 冉德林[1,2] 杨宝琦 刘永霞 刘红[1,2] 张福仁 ZHU Li;ZHAO Qing;WANG Na;RAN Delin;YANG Baoqi;LIU Yongxia;LIU Hong;ZHANG Furen(Hospital for Skin Diseases,Shandong First Medical University,Jinan 250022,China;Shandong Provincial Institute of Dermatology and Venereology,Shandong Academy of Medical Sciences,Jinan 250022,China)

机构地区：[1]山东第一医科大学附属皮肤病医院,山东济南250022 [2]山东省皮肤病性病防治研究所,山东济南250022

出　　处：《中国麻风皮肤病杂志》2024年第6期396-401,共6页China Journal of Leprosy and Skin Diseases

基　　金：山东省泰山学者青年专家计划(编号:tsqn202211346);山东省重点研发计划(重大科技创新工程)项目(编号:2021LCZX07)。

摘　　要：目的:明确一例可能由奥希替尼引起的中毒性表皮坏死松解症的致敏药物。方法:本例中毒性表皮坏死松解症患者发病前曾服用甲磺酸奥希替尼片、枸橼酸莫沙必利片及双氯芬酸钠缓释胶囊,为明确致敏药物采取Naranjo评分、ALDEN评分、淋巴细胞转化试验(lymphocyte transformation test, LTT)以及酶联免疫斑点试验进行验证;对既往报道的相关文献进行检索。结果:经过Naranjo评分、ALDEN评分,奥希替尼均得2分,在所有使用药物中得分最高且奥希替尼的LTT结果为阳性。文献检索中关于服用奥希替尼导致TEN的报道共7例。结论:结合Naranjo评分、ALDEN评分以及LTT的结果,确诊为由奥希替尼引起的中毒性表皮坏死松解症。Objective:To determine the sensitizing drug in a case of toxic epidermal necrolysis(TEN)possibly caused by osimertinib.Methods:The patient with TEN had previously taken osimertinib mesylate tablets,mosapride citrate tablets,and diclofenac sodium sustained-release capsules before the onset of the disease.To identify the sensitizing drug,the Naranjo score,ALDEN score,lymphocyte transformation test(LTT),and Enzyme-Linked Immunospot Assay(Elispot)were performed.Relevant literature was searched and analyzed for further information.Results:The osimertinib were both 2 points of Naranjo score and ALDEN score,which was the highest score among all used drugs,and the LTT result of osimertinib was positive.A total of 7 cases of TEN caused by osimertinib were reported in the literature.Conclusion:Combining the results of Naranjo score,ALDEN score and LTT,the patient was diagnosed with toxic epidermal necrolysis caused by osimertinib.

关 键 词：中毒性表皮坏死松解症 奥希替尼 表皮生长因子受体 

分 类 号：R969[医药卫生—药理学]