Mantadakis Elpis, Tsalkidis Aggelos, Paraskakis Emmanouel, Papadopoulou-Legbelou Kyriaki, Varlamis George, Evangeliou Athanassios, Chatzimichael Athanassios
Democritus University of Thrace, Department of Pediatrics, 6th Kilometer Alexandroupolis-Makris, 68100 Alexandroupolis, Thrace, Greece.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.10.2008.1076. Epub 2009 May 25.
Anticonvulsant hypersensitivity syndrome (AHS) is an acute, life-threatening, idiosyncratic drug reaction seen within 1-8 weeks after administration of an aromatic antiepileptic drug. The authors present the case of a 16-month-old boy who developed prolonged fever, a generalised pruritic rash and eosinophilia within 4 weeks after starting treatment with phenobarbital for complicated febrile seizures. He gradually fulfilled the diagnostic criteria for classical Kawasaki disease (KD), although the rash and the subsequent desquamation were atypical, he did not defervesce quickly with administration of corticosteroids and intravenous γ-globulin, and he had only two suggestive cardiac features of KD-that is, perivascular echogenicity of the coronary arteries and a small pericardial effusion. Other conditions considered in the differential diagnosis were excluded by appropriate extensive serological and microbiological studies. He recovered fully. This report shows that drugs such as phenobarbital may be responsible for febrile exanthematous illnesses that closely mimic KD.
抗惊厥药物超敏反应综合征（AHS）是一种急性、危及生命的特异质性药物反应，在使用芳香族抗癫痫药物后1 - 8周内出现。作者报告了一例16个月大的男孩，在用苯巴比妥治疗复杂性热性惊厥4周内出现持续发热、全身性瘙痒性皮疹和嗜酸性粒细胞增多。他逐渐符合经典川崎病（KD）的诊断标准，尽管皮疹及随后的脱皮不典型，使用糖皮质激素和静脉注射γ-球蛋白后未迅速退热，且他仅有KD的两个提示性心脏特征，即冠状动脉血管周围回声增强和少量心包积液。通过适当广泛的血清学和微生物学研究排除了鉴别诊断中考虑的其他疾病。他完全康复。本报告表明，苯巴比妥等药物可能是导致酷似KD的发热性皮疹疾病的原因。
