Howard P A, Engen P L, Dunn M I
Department of Pharmacy, University of Kansas Medical Center, Kansas City 66103.
DICP. 1991 Sep;25(9):929-32. doi: 10.1177/106002809102500904.
We report a life-threatening case of phenytoin hypersensitivity syndrome, a rare reaction primarily characterized by fever, skin eruptions, lymphadenopathy, eosinophilia, and hepatotoxicity. The reaction developed in a 27-year-old black man with surgically corrected tetralogy of Fallot who was treated with phenytoin for one month for exercise-induced sustained ventricular tachycardia. Phenytoin therapy was discontinued and the patient was treated with intravenous methylprednisolone; the therapy was later converted to oral prednisone. Clinical improvement was noted five days after admission and the patient was discharged on hospital day 14. This adverse reaction usually develops within six weeks of starting phenytoin therapy and may be fatal in up to 40 percent of the patients who develop hepatotoxicity. Early recognition of this relatively rare reaction is essential to prevent serious and potentially fatal complications.
我们报告了一例危及生命的苯妥英钠超敏反应综合征病例，这是一种罕见的反应，主要特征为发热、皮疹、淋巴结病、嗜酸性粒细胞增多和肝毒性。该反应发生在一名27岁接受过法洛四联症手术矫正的黑人男性身上，他因运动诱发的持续性室性心动过速接受苯妥英钠治疗一个月。停用苯妥英钠治疗，患者接受静脉注射甲泼尼龙治疗；随后治疗改为口服泼尼松。入院五天后病情出现临床改善，患者于住院第14天出院。这种不良反应通常在开始苯妥英钠治疗的六周内出现，在出现肝毒性的患者中，高达40%可能会致命。早期识别这种相对罕见的反应对于预防严重且可能致命的并发症至关重要。
