Bonaci-Nikolic Branka, Jeremic Ivica, Nikolic Milos, Andrejevic Sladjana, Lavadinovic Lidija
Institute of Allergy and Clinical Immunology, Clinical Center of Serbia, Belgrade, Serbia.
Intern Med. 2009;48(16):1471-4. doi: 10.2169/internalmedicine.48.2151. Epub 2009 Aug 17.
We present a patient who developed carbamazepine (CBZ)-induced Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome associated with high serum procalcitonin (PCT). The presentation (high fever, hepatosplenomegaly, leukocytosis), high PCT and CRP initially suggested sepsis, and he was treated with antibiotics, while CBZ was continued. The rash and hepatitis worsened. After withdrawal of CBZ, corticosteroid therapy was administered and the patient recovered with normalization of PCT. This case demonstrates that PCT may be increased in patients with DRESS. This is the first report of CBZ-induced DRESS associated with high PCT, and the second case of increased PCT in DRESS.
我们报告一名患者，其发生了卡马西平（CBZ）诱发的伴有嗜酸性粒细胞增多和全身症状的药物疹（DRESS）综合征，并伴有高血清降钙素原（PCT）。临床表现（高热、肝脾肿大、白细胞增多）、高PCT和CRP最初提示为脓毒症，患者接受了抗生素治疗，同时继续使用CBZ。皮疹和肝炎加重。停用CBZ后，给予糖皮质激素治疗，患者康复，PCT恢复正常。该病例表明，DRESS患者的PCT可能升高。这是首例与高PCT相关的CBZ诱发的DRESS报告，也是第二例DRESS患者PCT升高的病例。
