一名患有嗜酸性粒细胞增多、皮疹和多系统疾病的幼儿：服用氟西汀后出现药物性皮疹、嗜酸性粒细胞增多及全身症状综合征

A Young Child with Eosinophilia, Rash, and Multisystem Illness: Drug Rash, Eosinophilia, and Systemic Symptoms Syndrome After Receipt of Fluoxetine.

作者信息

Vignesh Pandiarajan, Kishore Janak, Kumar Ankur, Vinay Keshavamurthy, Dogra Sunil, Sreedharanunni Sreejesh, Prasun Giri Prabhas, Pal Priyankar, Ghosh Apurba

机构信息

Pediatric Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Serology and Molecular Virology, Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Education, Lucknow, Uttar Pradesh, India.

出版信息

Pediatr Dermatol. 2017 May;34(3):e120-e125. doi: 10.1111/pde.13131.

DOI:10.1111/pde.13131

PMID:28523892

Abstract

Drug rash, eosinophilia, and systemic symptoms (DRESS) syndrome is a severe systemic hypersensitivity reaction that usually occurs within 6 weeks of exposure to the offending drug. Diagnosis is usually straightforward in patients with pyrexia, skin rash, hepatitis, and eosinophilia with a preceding history of exposure to agents often associated with DRESS syndrome, such as aromatic anticonvulsants and sulfa drugs, but diagnosis of DRESS may still be a challenge. We report a 4-year-old child with probable DRESS syndrome complicated by multiple hematologic complications that developed 1 month after exposure to fluoxetine, a drug not known to be associated with such severe reactions.

摘要

药物疹、嗜酸性粒细胞增多及系统症状（DRESS）综合征是一种严重的全身性超敏反应，通常在接触致病药物后6周内发生。对于有发热、皮疹、肝炎及嗜酸性粒细胞增多，且之前有接触常与DRESS综合征相关药物（如芳香族抗惊厥药和磺胺类药物）病史的患者，诊断通常很简单，但DRESS的诊断仍可能具有挑战性。我们报告一名4岁儿童，可能患有DRESS综合征，并伴有多种血液学并发症，这些并发症在接触氟西汀1个月后出现，氟西汀是一种未知会引发此类严重反应的药物。