Kombila U D, Ka W, Mbaye F B R, Diouf N F, Fall L, Ouedraogo P, Koutonin A N E, Dia Kane Y, Oumar Toure Badiane N
Service de médecine interne, centre hospitalier universitaire de Libreville (CHUL), BP 9264, Libreville, Gabon; Clinique de pneumologie, centre hospitalier national universitaire de FANN (CHNUF), avenue Cheikh-ANTA-DIOP, BP 5035, Dakar, Sénégal.
Clinique de pneumologie, centre hospitalier national universitaire de FANN (CHNUF), avenue Cheikh-ANTA-DIOP, BP 5035, Dakar, Sénégal.
Rev Mal Respir. 2018 Jan;35(1):69-73. doi: 10.1016/j.rmr.2017.02.007. Epub 2018 Feb 9.
The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe drug-induced reaction.
We report the case of a 35-year-old man treated by RHEZ for a first episode of a smear positive pulmonary tuberculosis and who developed a DRESS syndrome due to pyrazinamide after twenty days of treatment, associated with a viral reactivation to Human Herpes Virus 6 (HHV6). He had a skin eruption, liver involvement and hypereosinophilia. He fully recovered after drug withdrawal, associated with local and general corticosteroids. He died two weeks after discharge.
Discovery of DRESS syndrome during tuberculosis treatment is an uncommon complication and requires a searching for the responsible drug. That should be difficult because tuberculosis drugs are often given as fixed-dose combination. Physicians have to bear in mind the potential role of pyrazinamide.
药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）是一种严重的药物不良反应。
我们报告了一名35岁男性患者的病例，该患者因涂片阳性的初发肺结核接受利福平、异烟肼、乙胺丁醇和吡嗪酰胺（RHEZ）治疗，治疗20天后因吡嗪酰胺发生DRESS综合征，并伴有人类疱疹病毒6型（HHV6）的病毒再激活。他出现了皮疹、肝脏受累和嗜酸性粒细胞增多。停药并联合局部和全身使用皮质类固醇后，他完全康复。出院两周后他去世了。
在结核病治疗期间发现DRESS综合征是一种罕见的并发症，需要寻找致病药物。这可能很困难，因为抗结核药物通常以固定剂量组合给药。医生必须牢记吡嗪酰胺的潜在作用。
