Reid James, Balcombe Nick, Ghosh Kris
Warwick Hospital, Geriatrics, Lakin Road, Warwick CV34 5BW, UK.
BMJ Case Rep. 2010;2010. doi: 10.1136/bcr.09.2009.2261. Epub 2010 Feb 8.
A case of antiepileptic hypersensitivity syndrome presenting as an acute septic illness is reported. A 67-year-old man, with a history of essential hypertension (treated with amlodipine) and recently diagnosed nocturnal epilepsy (treated with phenytoin), presented initially with an acute pneumonic illness with periorbital oedema. This was treated successfully with antibiotics and his phenytoin was changed to carbamazepine due to concerns regarding the periorbital oedema. He was re-admitted the following month with a history of weight loss, rigors, night sweats and high temperatures. Investigations revealed very high inflammatory markers. Despite extensive tests, no source of infection, autoimmune disease or malignancy was identified. The carbamazepine was then stopped and over the next 5 days the patient's symptoms gradually resolved. The patient's haematological and biochemical abnormalities returned to normal and he was discharged home. Since discharge he has been very well with no further sequelae.
报告了一例表现为急性脓毒症的抗癫痫药物超敏反应综合征病例。一名67岁男性，有原发性高血压病史（服用氨氯地平治疗），近期诊断为夜间癫痫（服用苯妥英钠治疗），最初表现为急性肺炎伴眶周水肿。经抗生素治疗成功，因担心眶周水肿，将其苯妥英钠改为卡马西平。次月，他因体重减轻、寒战、盗汗和高热再次入院。检查发现炎症指标非常高。尽管进行了广泛检查，但未发现感染源、自身免疫性疾病或恶性肿瘤。随后停用卡马西平，在接下来的5天里，患者症状逐渐缓解。患者的血液学和生化异常恢复正常，随后出院回家。出院后他情况良好，无进一步后遗症。
