别嘌醇片诱导的超敏反应综合征致暴发性1型糖尿病1例分析  

One case of fulminant type 1 diabetes mellitus induced by allopurinol tablets hypersensitivity syndrome

作　　者：严妍 刘乃一 乔玲 张毅[1] 杨晨[4] YAN Yan;LIU Naiyi;QIAO Ling;ZHANG Yi;YANG Chen(Department of Pharmacy,Tianjin Huanhu Hospital,Tianjin 300350,China;Department of Pharmacy,Tianjin City Tianjin Hospital,Tianjin 300211,China;Department of Pharmacy,the First Hospital of Xingtai,Xingtai Hebei 054001,China;Department of Pharmacy,General Hospital of Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]天津市环湖医院药剂科,天津300350 [2]天津市天津医院药剂科,天津300211 [3]邢台医学高等专科学校第一附属医院药剂科,河北邢台054001 [4]天津医科大学总医院药剂科,天津300052

出　　处：《中国药物警戒》2024年第9期1068-1070,1074,共4页Chinese Journal of Pharmacovigilance

摘　　要：目的 探讨暴发性1型糖尿病与别嘌醇诱发的药物超敏反应综合征的相关性,为临床提供参考。方法 研究1例携带HLA*B5801的患者使用别嘌醇后出现超敏反应并继发暴发性1型糖尿病的病例,结合相关文献,分析了其病例特点及药物导致不良反应的相关机制,并梳理了对此类患者的治疗措施。结果 患者胰岛功能完全丧失,今后需长期使用多次胰岛素注射方案控制血糖。既往研究和病例报告提示该不良反应与别嘌醇的使用可能相关。结论 此案例提示使用别嘌醇前应进行HLA-B*5801基因检测。临床医师应注意药物超敏反应综合征有继发自身免疫性疾病的风险。Objective To explore the correlation between fulminate type 1 diabetes mellitus and allopurinol-induced drug hypersensitivity syndrome,and to provide reference for clinical practice.Methods A patient with HLA-B*5801 allele who developed secondary fulminant type 1 diabetes mellitus after allopurinol-induced hypersensitivity syndrome and was reported.The characteristics of the case and the related mechanism of drug-induced adverse reactions were analyzed according to the relevant literature,and the treatment measures for such patients were sorted out.Results The patient lost islet function completely and needed long-term multiple daily insulin injection to control blood glucose in the future.Previous studies and case reports suggest that this adverse event may be related to the use of allopurinol.Conclusion This case suggests that HLA-B*5801 gene testing should be performed before allopurinol treatment.Clinicians should be aware of the risk of secondary autoimmune diseases associated with drug-induced hypersensitivity syndrome.

关 键 词：暴发性1型糖尿病 别嘌醇 不良反应 药物诱导超敏反应综合征 HLA-B*5801 药物性皮疹 药学监护 

分 类 号：R994.11[医药卫生—毒理学] R696.3[医药卫生—药学]