口服青霉素类药物引起的严重血清病样反应：三例报告

Severe serum sickness-like reaction to oral penicillin drugs: three case reports.

作者信息

Tatum A J, Ditto A M, Patterson R

机构信息

Department of Medicine and the Ernest S. Bazley Asthma and Allergic Diseases Center of Northwestern Memorial Hospital and Northwestern University Medical School, Chicago, Illinois, USA.

出版信息

Ann Allergy Asthma Immunol. 2001 Mar;86(3):330-4. doi: 10.1016/S1081-1206(10)63308-X.

DOI:10.1016/S1081-1206(10)63308-X

PMID:11289334

Abstract

BACKGROUND

Because the use of heterologous sera has diminished, the incidence of serum sickness has declined. However, serum sickness-like reactions to nonprotein drugs continue to occur.

METHODS

We report three cases of severe serum sickness-like reactions in adults to oral penicillin drugs.

RESULTS

In each patient, significant symptom resolution occurred within 24 hours of starting therapy with oral corticosteroids.

CONCLUSIONS

Serum sickness-like reactions to oral penicillin drugs may be more common than reported in the literature and can be very severe. No specific laboratory finding is universally present or definitively diagnostic. As with classic serum sickness, the diagnosis of serum sickness-like reaction is made clinically. In severe cases such as those presented here with debilitating joint symptoms or life-threatening angioedema, a diagnostic-therapeutic trial of prednisone, 40 to 60 mg at least once daily, is warranted.

摘要

背景

由于异源血清的使用减少，血清病的发病率已有所下降。然而，对非蛋白质药物的血清病样反应仍持续发生。

方法

我们报告了3例成人因口服青霉素类药物发生严重血清病样反应的病例。

结果

每位患者在开始口服糖皮质激素治疗后的24小时内，症状均有明显缓解。

结论

口服青霉素类药物引起的血清病样反应可能比文献报道的更为常见，且可能非常严重。没有普遍存在或具有确诊意义的特定实验室检查结果。与经典血清病一样，血清病样反应的诊断基于临床。在出现如本文所述的严重关节症状或危及生命的血管性水肿等严重病例中，进行泼尼松诊断性治疗试验是必要的，剂量为每日至少一次40至60毫克。