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患儿为 11 岁白人男孩,因幼年特发性关节炎接受柳氮磺胺吡啶和萘普生治疗时出现药物超敏反应综合征,且人类疱疹病毒 6 被激活。

DRESS-syndrome on sulfasalazine and naproxen treatment for juvenile idiopathic arthritis and reactivation of human herpevirus 6 in an 11-year-old Caucasian boy.

机构信息

Clinical Pharmacology Department, Hospital Universitario La Paz, School of Medicine, Universidad Autónoma de Madrid, Spain.

出版信息

J Clin Pharm Ther. 2010 Jun;35(3):365-70. doi: 10.1111/j.1365-2710.2009.01081.x.

Abstract

DRESS-syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a severe drug-induced hypersensitivity syndrome characterized by diffuse maculopapular rash, lymphadenopathy, multivisceral involvement, eosinophilia and atypical lymphocytes with a mortality rate of 10-40% (Seminars in Cutaneous Medicine and Surgery, 1, 250). It is described in adults treated with aromatic antiepileptics and less frequently with sulphonamides, and non-steroidal anti-inflammatory drugs (Clinics in Dermatology, 23, 171; Pediatrics, 108, 485). We report on an 11-year-old Caucasian boy hospitalized with a skin eruption, lymphadenopathy, acute hepatitis, renal tubular involvement, haematological abnormalities and human-herpevirus-6 reactivation, treated with sulfasalazine and naproxen for juvenile idiopathic arthritis (JIA). This is the first report in children with rheumatic disease and highlights the possibility of sulfasalazine and naproxen-induced-DRESS-syndrome in children with JIA.

摘要

药物反应伴嗜酸性粒细胞增多和全身症状(DRESS 综合征)是一种严重的药物诱导的超敏反应综合征,其特征为弥漫性斑丘疹、淋巴结病、多脏器受累、嗜酸性粒细胞增多和非典型淋巴细胞,死亡率为 10-40%(《皮肤医学与外科学研讨会》,1,250)。它在接受芳香族抗癫痫药治疗的成人中以及较少见的磺胺类药物和非甾体抗炎药(《皮肤病学临床》,23,171;《儿科学》,108,485)中被描述。我们报告了一例 11 岁的白人男孩,因幼年特发性关节炎(JIA)接受柳氮磺胺吡啶和萘普生治疗后出现皮疹、淋巴结病、急性肝炎、肾小管受累、血液学异常和人类疱疹病毒-6 再激活而住院。这是风湿性疾病儿童中的首例报告,并强调了 JIA 儿童中柳氮磺胺吡啶和萘普生诱导的 DRESS 综合征的可能性。

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