抗精神病药致药物超敏反应综合征复发1例  

A case of recurrent drug-induced hypersensitivity syndrome caused by antipsychotics

作　　者：王丹[1] 王茜[1] Wang Dan;Wang Qian(National Clinical Research Center for Mental Disorders&National Center for Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京安定医院、国家精神疾病医学中心、国家精神心理疾病临床医学研究中心,北京100088

出　　处：《中华精神科杂志》2024年第12期844-847,共4页Chinese Journal of Psychiatry

摘　　要：药物超敏反应综合征(drug induced hypersensitivity syndrome, DIHS), 又称伴嗜酸性粒细胞增多和系统症状的药物反应(drug reaction and eosinophilia with systemic symptoms, DRESS), 是一种由特定药引起、累及内脏器官、威胁生命的重症药疹。本文报告了1例双相障碍患者服用抗精神病药后引发DRESS综合征, 并由于过早减停糖皮质激素导致DRESS复发的个案, 以此提示临床医生对既往有DRESS发作的患者, 应详细了解患者用药史, 并谨慎为其处方新的抗精神病药, 缓慢减停类固醇药物, 避免复发。同时结合文献对DRESS的临床表现、复发特征以及药物相关基因检测进行复习, 以提示临床医生重视DRESS的预防、早期诊断及干预。Drug-induced hypersensitivity syndrome(DIHS),also known as drug reaction and eosinophilia with systemic symptoms(DRESS),is a severe,internal organ involvement,life-threatening drug rash that may occur with exposure to specific medications.This article reports a case of bipolar disorder patient who developed DRESS syndrome after taking antipsychotics,and experienced a recurrence of DRESS due to the premature tapering and discontinuation of corticosteroids.This case highlights the importance of clinicians carefully reviewing the medication history of patients with previous DRESS episodes,being cautious when prescribing new antipsychotics,and tapering glucocorticoids slowly to avoid recurrence.This article also discusses the clinical manifestations,recurrence characteristics,and drug-related genetic testing of DRESS,emphasizing the need for clinicians to focus on prevention,early diagnosis,and intervention.

关 键 词：抗精神病药 药物超敏反应综合征 伴嗜酸性粒细胞增多和系统症状的药物反应 复发 双相情感障碍 

分 类 号：R971.4[医药卫生—药品]