Morimoto Mitsuaki, Watanabe Yutaka, Arisaka Takehiro, Takada Atsushi, Tonogi Morio, Yamane Gen-yuki, Fukushima Daihei, Takahashi Shin-ichi, Tanaka Yoichi
Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Japan.
Bull Tokyo Dent Coll. 2011;52(3):135-42. doi: 10.2209/tdcpublication.52.135.
The patient was a 51-year-old man who had been prescribed carbamazepine for right third-branch trigeminal neuralgia. He had stopped taking the medication after the neuralgia resolved. When the neuralgia recurred, he resumed medication, and about 1 month later he developed fever, fatigue, cervical lymphadenopathy, generalized skin flushing, facial edema and perioral vesicles, and was admitted to Ichikawa General Hospital, Tokyo Dental College. Oral findings showed reddening and erosion of the buccal mucosa. Routine laboratory examination revealed leukocytosis and hepatic dysfunction. Human herpesvirus 6 antibody titer remarkably increased during development of eruptions. These findings led to a diagnosis of drug-induced hypersensitivity syndrome. Carbamazepine was discontinued, and prednisolone (30 mg/day) was started and tapered based on improvement of symptoms. Because skin symptoms recurred after he was discharged 15 days after admission, the dose of prednisolone was increased and the symptoms finally disappeared. The patient has experienced no further recurrence.
该患者为一名51岁男性，因右侧三叉神经第三支神经痛曾服用卡马西平。神经痛缓解后他停用了该药物。当神经痛复发时，他重新开始服药，大约1个月后出现发热、乏力、颈部淋巴结病、全身性皮肤潮红、面部水肿和口周水疱，随后入住东京齿科大学市川综合医院。口腔检查发现颊黏膜发红和糜烂。常规实验室检查显示白细胞增多和肝功能障碍。在皮疹出现期间，人类疱疹病毒6抗体滴度显著升高。这些发现导致诊断为药物性超敏反应综合征。停用卡马西平，开始使用泼尼松龙（30毫克/天），并根据症状改善情况逐渐减量。由于入院15天后出院时皮肤症状复发，泼尼松龙剂量增加，症状最终消失。患者未再复发。
