Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Int J Dermatol. 2018 Feb;57(2):177-182. doi: 10.1111/ijd.13837. Epub 2017 Nov 22.
Extracorporeal treatments such as hemodialysis and plasma exchange are lifesaving measures in the treatment of drug poisoning. This treatment method generally is not used for severe cutaneous and systemic drug reactions.
Here, we describe three cases wherein hemodialysis therapy was instrumental in reversing the adverse drug reaction.
In the cases of severe cutaneous drug reactions reviewed, patients presented with linear immunoglobulin A bullous dermatosis, acute generalized exanthematous pustulosis, and toxic epidermal necrolysis. Salvage treatment with hemodialysis therapy drastically influenced the course of disease, resulting in remission.
This novel and highly effective treatment option is not considered in current algorithms for adverse drug reactions. Hence, in addition to the rarity of these reactions, the main limitation of the study is the small number of patients. Hemodialysis can substantially alter the prognosis and, in some cases, be a lifesaving treatment for patients with severe adverse cutaneous drug reaction associated with systemic toxicity.
体外治疗，如血液透析和血浆置换，是治疗药物中毒的救命措施。这种治疗方法一般不适用于严重的皮肤和全身药物反应。
在这里，我们描述了三例通过血液透析治疗逆转药物不良反应的病例。
在回顾的严重皮肤药物反应病例中，患者表现为线性免疫球蛋白 A 大疱性皮病、急性泛发性发疹性脓疱病和中毒性表皮坏死松解症。血液透析治疗的抢救治疗极大地影响了疾病的进程，导致缓解。
这种新颖且高效的治疗选择在当前药物不良反应的算法中并未被考虑。因此，除了这些反应的罕见性之外，本研究的主要限制是患者数量较少。血液透析可以显著改变预后，在某些情况下，对于伴有全身毒性的严重不良皮肤药物反应患者，血液透析是一种救命的治疗方法。
