Ono Yuko, Shimo Tsuyoshi, Shirafuji Yoshinori, Hamada Toshihisa, Masui Masanori, Obata Kyoichi, Yao Mayumi, Kishimoto Koji, Sasaki Akira
Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8525, Japan.
Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8525, Japan.
Case Rep Dent. 2016;2016:4605231. doi: 10.1155/2016/4605231. Epub 2016 Nov 3.
An 88-year-old man was diagnosed with trigeminal neuralgia, and treatment of carbamazepine 200 mg/day was initiated. About 6 weeks later, the patient developed a skin rash accompanied by fever. He was admitted to hospital and diagnosed with drug-induced hypersensitivity syndrome (DIHS) caused by carbamazepine. Oral carbamazepine treatment was stopped, but blood tests showed acute liver and acute renal failure. Drug-induced lymphocyte stimulation test (DLST) for carbamazepine, human herpes virus-6 (HHV-6) IgG, and CMV-HRP were negative. Oral prednisolone therapy was begun 18 days later. The titer of HHV-6 IgG antibodies was then detected (640 times). Following treatment, liver and renal function improved and the erythema disappeared.
一名88岁男性被诊断为三叉神经痛,开始服用卡马西平,剂量为每日200毫克。大约6周后,患者出现皮疹并伴有发热。他被收治入院,诊断为卡马西平引起的药物性超敏反应综合征(DIHS)。口服卡马西平治疗停止,但血液检查显示急性肝肾功能衰竭。卡马西平药物诱导淋巴细胞刺激试验(DLST)、人疱疹病毒6型(HHV-6)IgG和巨细胞病毒-辣根过氧化物酶(CMV-HRP)均为阴性。18天后开始口服泼尼松龙治疗。随后检测到HHV-6 IgG抗体滴度(640倍)。经过治疗,肝肾功能改善,红斑消失。