Criado Paulo Ricardo, Criado Roberta Fachini Jardim, Avancini João de Magalhães, Santi Claudia Giuli
Faculdade de Medicina, Universidade de Sao Paulo, Brazil.
An Bras Dermatol. 2012 May-Jun;87(3):435-49. doi: 10.1590/s0365-05962012000300013.
The Drug Reaction with Eosinophilia and Systemic Symptoms syndrome, also known as Drug Induced Hypersensitivity Syndrome presents clinically as an extensive mucocutaneous rash, accompanied by fever, lymphadenopathy, hepatitis, hematologic abnormalities with eosinophilia and atypical lymphocytes, and may involve other organs with eosinophilic infiltration, causing damage to several systems, especially to the kidneys, heart, lungs, and pancreas. Recognition of this syndrome is of paramount importance, since the mortality rate is about 10% to 20%, and a specific therapy may be necessary. The pathogenesis is related to specific drugs, especially the aromatic anticonvulsants, altered immune response, sequential reactivation of herpes virus and association with HLA alleles. Early recognition of the syndrome and withdrawal of the offending drug are the most important and essential steps in the treatment of affected patients. Corticosteroids are the basis of the treatment of the syndrome, which may be associated with intravenous immunoglobulin and, in selected cases, Ganciclovir. The article reviews the current concepts involving this important manifestation of adverse drug reaction.
药物超敏反应伴嗜酸性粒细胞增多和全身症状综合征，也称为药物诱导的超敏反应综合征，临床症状表现为广泛的黏膜皮肤皮疹，伴有发热、淋巴结病、肝炎、血液学异常伴嗜酸性粒细胞增多和非典型淋巴细胞，且可能累及其他伴有嗜酸性粒细胞浸润的器官，对多个系统造成损害，尤其是肾脏、心脏、肺和胰腺。认识到这种综合征至关重要，因为其死亡率约为10%至20%，可能需要特定的治疗方法。其发病机制与特定药物有关，尤其是芳香族抗惊厥药、免疫反应改变、疱疹病毒的序贯再激活以及与人类白细胞抗原（HLA）等位基因的关联。早期识别该综合征并停用致病药物是治疗受影响患者最重要和必不可少的步骤。皮质类固醇是该综合征治疗的基础，可能联合静脉注射免疫球蛋白，在某些特定情况下还可使用更昔洛韦。本文综述了关于药物不良反应这一重要表现的当前概念。
