Department of Dermatology, Changi General Hospital, Singapore 529889.
Singapore Med J. 2012 Nov;53(11):e231-2.
Drug hypersensitivity syndrome (DHS) is an idiosyncratic systemic reaction to a drug. The clinical presentation of this syndrome comprises a diverse spectrum, ranging from mild to fulminating organ failure. Nonspecific gastrointestinal symptoms are common in DHS, but severe morbidities and mortalities attributed to gut disease in DHS are rarely described. We present a case of DHS with significant gastrointestinal symptoms of prolonged profuse watery diarrhoea and persistent hypokalaemia requiring judicious intravenous water and electrolyte replacement. The symptoms resolved only after the introduction of intravenous hydrocortisone. It is important to consider intravenous corticosteroids if the gastrointestinal system is involved, as accelerated gut motility and mucosal damage would affect absorption of oral medications. Supportive treatment with the monitoring of fluid and electrolytes status and judicious replacement remains fundamental in the management of DHS patients with gut involvement.
药物超敏反应综合征（DHS）是一种对药物的特发性全身反应。该综合征的临床表现呈多样化，从轻症到暴发性器官衰竭不等。非特异性胃肠道症状在 DHS 中很常见，但 DHS 中严重的胃肠道疾病导致的发病率和死亡率很少被描述。我们报告了一例 DHS 病例，其胃肠道症状明显，表现为长时间大量水样腹泻和持续低钾血症，需要谨慎静脉补液和电解质替代治疗。只有在静脉注射氢化可的松后，症状才得以缓解。如果胃肠道受累，应考虑静脉用皮质类固醇，因为加速的肠道蠕动和黏膜损伤会影响口服药物的吸收。在 DHS 患者出现胃肠道受累时，支持治疗、监测液体和电解质状态以及谨慎替代治疗仍然是基本的治疗方法。
