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药物超敏反应伴嗜酸性粒细胞增多和全身症状的回顾性研究。

A retrospective study of DRESS - drug reaction with eosinophilia and systemic symptoms.

作者信息

Mehrholz Dorota, Urban Anna Emilia, Herstowska Marta, Nowicki Roman, Cubała Wiesław, Barańska-Rybak Wioletta

机构信息

Klinika Dermatologii, Wenerologii i Alergologii Gdańskiego Uniwersytetu Medycznego.

Klinika Psychiatrii Dorosłych Gdańskiego Uniwersytetu Medycznego.

出版信息

Psychiatr Pol. 2017 Dec 30;51(6):1079-1093. doi: 10.12740/PP/74358.

Abstract

OBJECTIVES

DRESS (drug reaction with eosinophilia and systemic syndrome) is qualified as hypersensitivity after drug reaction. This syndrome may occur due to any medication intake. There are three main groups of symptoms defining DRESS: skin lesions, hematological abnormalities and internal organ involvement.

METHODS

A retrospective study was performed on a group of 261 patients with drug reactions hospitalized in the Clinic of Dermatology from 2004 until 2017.

RESULTS

There were ten cases of DRESS of 261 hypersensitivity drug reactions observed in the Clinic. The drug which most frequently caused DRESS in the studied group was carbamazepine - six patients (60%). Lamotrigine was the cause of DRESS in two cases, oxycarbamazepine in one patient and dexketoprofen in one patient. The skin lesion was present in 100% patients. Mainly it was coalescing hemorrhagic rash accompanied by face edema. Eosinophilia was noticed in 80% of patients and the presence of atypical lymphocytes - in 40%. The main infiltrate organ was liver in 8 cases.

CONCLUSIONS

DRESS diagnosis should be taken into consideration especially in patients treated eith antiepileptic drugs. Early diagnosis and drug discontinuation can contribute to preventing serious complications of DRESS.

摘要

目的

药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS)被认定为药物反应后的超敏反应。该综合征可能因任何药物摄入而发生。定义DRESS的主要有三组症状:皮肤病变、血液学异常和内脏器官受累。

方法

对2004年至2017年在皮肤科诊所住院的261例药物反应患者进行回顾性研究。

结果

在该诊所观察到的261例超敏药物反应中有10例DRESS病例。研究组中最常引起DRESS的药物是卡马西平——6例患者(60%)。拉莫三嗪导致2例DRESS,奥卡西平导致1例,右酮洛芬导致1例。100%的患者出现皮肤病变。主要是融合性出血性皮疹伴面部水肿。80%的患者出现嗜酸性粒细胞增多,40%的患者出现非典型淋巴细胞。主要受累器官为肝脏,共8例。

结论

尤其是在接受抗癫痫药物治疗的患者中,应考虑DRESS诊断。早期诊断和停药有助于预防DRESS的严重并发症。

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