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双相情感障碍患者使用拉莫三嗪继发迟发性史蒂文斯-约翰逊综合征

Delayed Stevens-Johnson Syndrome Secondary to the Use of Lamotrigine in Bipolar Mood Disorder.

作者信息

Jha Kunal Kishor, Chaudhary Durgesh Prasad, Rijal Tshristi, Dahal Semanta

机构信息

Department of Critical Care Medicine, Geisinger Medical Center, Danville, PA 17821, USA.

Department of Internal Medicine, Norvic International Hospital, Kathmandu, Nepal.

出版信息

Indian J Psychol Med. 2017 Mar-Apr;39(2):209-212. doi: 10.4103/0253-7176.203130.

Abstract

Lamotrigine is a mood-stabilizing drug used in maintenance treatment of bipolar I disease. There are adverse effects with lamotrigine such as a headache, blurred vision, diplopia, somnolence, ataxia, dizziness, rash, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis. SJS is a life-threatening, blistering mucocutaneous disease. SJS is characterized by the presence of flat, diffuse erythematous maculopapular rashes with the involvement of <10% of the body surface area. Standard trigger is drugs including anticonvulsants, antibiotics, and infection. We report a case where a patient developed SJS secondary to delayed-type hypersensitivity reaction after 6 months of the use of lamotrigine, while his initial response during the first 6 months did not show any sign of SJS.

摘要

拉莫三嗪是一种用于双相I型障碍维持治疗的心境稳定剂。拉莫三嗪存在一些不良反应,如头痛、视力模糊、复视、嗜睡、共济失调、头晕、皮疹、史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死松解症。SJS是一种危及生命的水疱性皮肤黏膜疾病。SJS的特征是出现扁平、弥漫性红斑性斑丘疹,累及体表面积不到10%。常见诱因包括抗惊厥药、抗生素等药物以及感染。我们报告一例患者,在使用拉莫三嗪6个月后因迟发型超敏反应继发SJS,而最初6个月的反应未显示出任何SJS迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5c8/5385756/3a1034cfe5f1/IJPsyM-39-209-g001.jpg

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