Ghandourah Hasan, Bhandal Samarjeet, Brundler Marie-Anne, Noseworthy Mary
Hospital for Sick Children, Toronto, Ontario, Canada.
Alberta Children's Hospital, Calgary, Alberta, Canada.
BMJ Case Rep. 2016 Jan 29;2016:bcr2014207182. doi: 10.1136/bcr-2014-207182.
A 14-year-old girl who was known to have a seizure disorder and on lamotrigine treatment was admitted to the hospital, with a history of rash, fever and cough. Her condition deteriorated with clinical features suggestive of anticonvulsant hypersensitivity syndrome (ACHS) complicated with bronchiolitis obliterans organising pneumonia (BOOP). Her chest CT showed multifocal parenchymal opacities and lung biopsy was typical for BOOP. Initially, the lamotrigine was discontinued since the onset of the rash, then she was treated for pneumonia with antibiotics, which may have delayed the diagnosis. Eventually, BOOP was considered and she was treated with a high dose of corticosteroid. She improved clinically and her repeated chest CT showed a marked resolution of the lesions. This case illustrates the possible occurrence of BOOP as a complication of ACHS secondary to lamotrigine treatment.
一名14岁已知患有癫痫症且正在接受拉莫三嗪治疗的女孩因皮疹、发热和咳嗽病史入院。她的病情恶化，临床特征提示抗惊厥药超敏反应综合征（ACHS）并发闭塞性细支气管炎伴机化性肺炎（BOOP）。她的胸部CT显示多灶性实质混浊，肺活检符合BOOP的典型表现。起初，自皮疹出现后停用了拉莫三嗪，然后她接受了抗生素治疗肺炎，这可能延误了诊断。最终，考虑为BOOP并给予大剂量皮质类固醇治疗。她的临床症状有所改善，重复胸部CT显示病变明显消退。该病例说明了BOOP作为拉莫三嗪治疗继发的ACHS并发症的可能发生情况。
