抗结核药物超敏反应综合征致暴发性1型糖尿病1例并文献复习  

A case of fulminant type 1 diabetes mellitus caused by anti-tuberculosis drug-induced hypersensitivity syndrome and literature review

作　　者：汪敏[1] 吴迪 陈泽莹 冯治宇[1] 袁园[1] 张宏[1] 黄显林 邝浩斌[1] WANG Min;WU Di;CHEN Zeying;FENG Zhiyu;YUAN Yuan;ZHANG Hong;HUANG Xianlin;KUANG Haobin(Department of Tuberculosis,Guangzhou Chest Hospital,Guangdong,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院结核内科,广东广州510095

出　　处：《中国医药科学》2024年第12期192-194,198,共4页China Medicine And Pharmacy

基　　金：广东省医学科研基金项目(B2023259);广东省广州市医学重点学科结核病学(2021-2023);广东省广州市科技计划项目(2023A03J0539)。

摘　　要：目的探讨抗结核治疗中抗结核药物超敏反应综合征(DIHS)致暴发性1型糖尿病(FT1DM)的诊疗经验。方法回顾性分析1例抗结核药物(ATD)引起DIHS致FT1DM患者的病情变化,结合治疗经过等临床资料,总结诊疗方法。结果病例在使用抗结核药物后出现皮疹、肝功能受损,治疗过程中突然出现糖尿病酮症酸中毒,完善胰岛功能、胰岛素相关抗体、糖化血红蛋白等相关检查后确诊为FT1DM,经积极治疗后患者症状、检验指标改善。结论ATD引起的DIHS可导致FT1DM的发生,出现DIHS时,应注意临床特征变化,完善相关检查,及早诊治。Objective To explore the diagnosis and treatment experience of fulminant type 1 diabetes mellitus(FT1DM)caused by drug-induced hypersensitivity syndrome(DIHS)induced by anti-tuberculosis drugs(ATD)in anti-tuberculosis therapy.Methods A case of FT1DM caused by DIHS induced by anti-tuberculosis drugs was analyzed retrospectively,and the diagnosis and treatment method were summarized in combination with the clinical data such as treatment course.Results After using anti-tuberculosis drugs,the patient developed rash and liver function injury as well as diabetic ketoacidosis suddenly occurred during the treatment.The patient was diagnosed as FT1DM after the related examinations such as islet function,insulin-related antibody,and glycosylated hemoglobin.After active treatment,the patient’s symptoms and test indicators improved.Conclusion DIHS induced by ATD can lead to FT1DM.Therefore,when DIHS occurs,we should pay attention to the changes of clinical characteristics,improve relevant ex aminations,and make early diagnosis and treatment.

关 键 词：抗结核药物 药物超敏反应综合征 暴发性1型糖尿病 文献复习 

分 类 号：R969[医药卫生—药理学]