利格列汀致多形性红斑药疹  

Erythema multiforme-like drug eruption induced by linagliptin

作　　者：陈诗狄 贾珂[2] 刘芳 Chen Shidi;Jia Ke;Liu Fang(Department of Pharmacy,Beijing Haidian Hospital,Beijing 100080,China;Department of Neurology,Beijing Haidian Hospital,Beijing 100080,China;Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京市海淀医院药剂科,北京100080 [2]北京市海淀医院神经内科,北京100080 [3]北京大学第三医院药剂科,北京100191

出　　处：《药物不良反应杂志》2024年第10期633-635,共3页Adverse Drug Reactions Journal

摘　　要：1例62岁男性患者因脑梗死合并高血压病和糖尿病给予抗血小板、降脂、降糖等治疗。9 d后,因血糖控制不佳,加用利格列汀(5 mg口服、1次/d)和艾托格列净(5 mg口服、1次/d)。服药后次日,患者胸前出现散发皮疹,之后逐渐加重,躯干和四肢近端出现大量环形靶样红斑,伴疼痛,无明显瘙痒;服药后第8天皮肤科医师会诊诊断为药物性皮疹,考虑可能为利格列汀诱发。停用上述2药,给予甲泼尼龙40 mg静脉滴注、1次/d,并予抗组胺药物等对症治疗。治疗第4天,患者胸前及背部皮疹融合成大片,伴大量脱屑;将甲泼尼龙加量至80 mg静脉滴注、1次/d。治疗第7天,患者皮疹较前略消退,甲泼尼龙减量为60 mg静脉滴注、1次/d。治疗第10天,患者皮疹较前明显好转,逐渐停用糖皮质激素和抗组胺药等。2周后随访,患者皮疹消退。A 62-year-old male patient received antiplatelet aggregation,lipid-lowering and hypo-glycemic therapy due to cerebral infarction complicated with hypertension and diabetes.After 9 days,linagliptin(5 mg orally once daily)and ertugliflozin(5 mg orally once daily)were added due to the poor blood glucose control.The next day after taking the 2 drugs,he developed a scattered rash on the chest,which gradually worsened.A large number of circular target-like erythema appeared on the trunk andproxi-mal limbs,accompanied by pain but no obvious itching.On the 8th day after taking the 2 drugs,the dermatol-ogist consulted and the patient was diagnosed with drug-induced rash,which was considered to be induced by linagliptin.Then linagliptin and ertugliflozin were discontinued.The patient received intravenous infu-sion of methylprednisolone 40 mg once daily,along with symptomatic treatments such as antihistamines.On the 4th day of treatments,the rash on his chest and back merged into a large area,accompanied by signifi-cant flaking;the dosage of methylprednisolone was increased to 80 mg by intravenous injection once daily.On the 7th day of treatments,the rash slightly subsided,and the dosage of methylprednisolone was reduced to 60 mg by intravenous injection once daily.On the 10th day of treatments,the rash was improved signifi-cantly.Corticosteroids and antihistamines were gradually discontinued.At a two-week follow-up,the patient′s rash disappeared.

关 键 词：药疹 多形性红斑 利格列汀 降糖药 

分 类 号：R969.3[医药卫生—药理学]