环孢菌素A联合糖皮质激素成功治疗反复发作的药物超敏反应综合征1例  

Successful treatment of a case of recurrent drug reaction syndrome with a combination of cyclosporine and glucocorticoids

作　　者：包凌云 刘雯敏 聂小娟 李圆圆 宋亚丽 BAO Lingyun;LIU Wenmin;NIE Xiaojuan;LI Yuanyuan;SONG Yali(Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Public Health Clinical Center Affiliated to Shandong University,Jinan 250102,China)

机构地区：[1]山东大学齐鲁医学院,山东济南250012 [2]山东第一医科大学附属省立医院,山东济南250021 [3]山东大学附属公共卫生临床中心,山东济南250102

出　　处：《皮肤性病诊疗学杂志》2025年第3期206-210,共5页Journal of Diagnosis and Therapy on Dermato-venereology

摘　　要：报告环孢菌素A联合糖皮质激素成功治疗反复发作的药物超敏反应综合征1例。患者女,36岁,因全身反复红斑、丘疹伴瘙痒1个月就诊。皮肤科检查:面部略肿胀,全身弥漫性分布粟粒大小红色斑丘疹,双侧耳后、颈侧、腋下、腹股沟区触及肿大淋巴结。实验室检查:白细胞11.36×10^(9)/L,嗜酸性粒细胞计数(EO)0.66×10^(9)/L,谷草转氨酶181 U/L,谷丙转氨酶370 U/L。IgE 21500 IU/mL,HHV-6-DNA(+),CMV-DNA(+),EBV-DNA 1.00×10^(5)copies/mL。诊断:药物超敏反应综合征。予环孢菌素A联合糖皮质激素治疗,辅以抗病毒治疗。患者全身皮疹逐渐消退,残留少许色素沉着斑,未再发热。随访3个月余未复发。A case of recurrent drug reaction with eosinophilia and systemic symptoms successfully treated with cyclosporine combined with glucocorticoids is reported.A 36-year-old female presented with an one-month history of recurrent,itchy erythemas and papules covering her entire body.Dermatological examination revealed a swollen face,and millet-sized macules and papules all over the body.Enlarged lymph nodes were palpated bilaterally behind the ears,on the sides of the neck,in the axillae,and in the inguinal areas.The results of laboratory tests at admission were as the follows:leukocyte count,11.36×10^(9)/L;absolute eosinophil count(EO),0.66×10^(9)/L;glutamic oxaloacetic transaminase,181 U/L;glutamic pyruvic transaminase,370 U/L;IgE count,21500 IU/mL;positive for both HHV-6-DNA and CMV-DNA,and an EBV-DNA count,1.00×10^(5)copies/mL.The diagnosis was drug reaction with eosinophilia and systemic symptoms(DRESS).The patient was treated with cyclosporin A and glucocorticoids,supplemented with antiviral therapy.The patient's generalized rashes gradually subsided after the treatment,leaving a few hyperpigmented spots.The patient was followed up for more than 3 months without recurrence.

关 键 词：药物超敏反应综合征 环孢菌素A 药物特异性T细胞 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]