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一名2岁以下男孩的万古霉素诱发的史蒂文斯-约翰逊综合征：通过颗粒溶素快速检测进行早期诊断

Vancomycin-Induced Stevens-Johnson Syndrome in a Boy Under 2 Years Old: An Early Diagnosis by Granulysin Rapid Test.

作者信息

Lin You-Cheng, Sheu Ji-Nan, Chung Wen-Hung, Pan Ren-You, Hung Chu-Ju, Cheng Jen-Jung, Hsiao Yu-Ping

机构信息

School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Department of Medical Education, Chung Shan Medical University Hospital, Taichung, Taiwan.

出版信息

Front Pediatr. 2018 Mar 13;6:26. doi: 10.3389/fped.2018.00026. eCollection 2018.

DOI:10.3389/fped.2018.00026
PMID:29594082
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5859217/
Abstract

Stevens-Johnson syndrome (SJS) is a life-threatening disease, which is mainly ascribed to drugs, such as sulfonamides and psychoepileptics. In this article, we present a pediatric case of vancomycin-induced SJS and an alternative diagnostic algorithm. The patient presented with multiple target-like rashes and vesicles throughout the whole body after receiving vancomycin. Despite the fact that skin biopsy remains the gold standard for diagnosing SJS, the granulysin rapid test by immunochromatographic assay is a non-invasive option for children. In this article, we describe our use of the Algorithm of Drug causality for Epidermal Necrolysis and a modified T-cell activation assay for granzyme B and interferon gamma to screen for the culprit drug. Moreover, we applied the granulysin rapid test as an early diagnosis method for children with drug-induced SJS.

摘要

史蒂文斯-约翰逊综合征（SJS）是一种危及生命的疾病，主要归因于药物，如磺胺类药物和抗癫痫精神药物。在本文中，我们介绍了一例万古霉素诱发的儿童SJS病例及一种替代诊断算法。该患者在接受万古霉素治疗后全身出现多处靶样皮疹和水疱。尽管皮肤活检仍是诊断SJS的金标准，但免疫层析法进行的颗粒溶素快速检测对儿童来说是一种非侵入性选择。在本文中，我们描述了我们使用表皮坏死松解症药物因果关系算法以及用于颗粒酶B和干扰素γ的改良T细胞活化检测来筛查罪魁祸首药物。此外，我们将颗粒溶素快速检测应用于药物性SJS儿童的早期诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8221/5859217/ecddc10db84b/fped-06-00026-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8221/5859217/86544ca79f99/fped-06-00026-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8221/5859217/7f73eb20a54c/fped-06-00026-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8221/5859217/ecddc10db84b/fped-06-00026-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8221/5859217/86544ca79f99/fped-06-00026-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8221/5859217/7f73eb20a54c/fped-06-00026-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8221/5859217/ecddc10db84b/fped-06-00026-g003.jpg

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Drug Saf. 2019 Jun;42(6):797-801. doi: 10.1007/s40264-019-00818-1.
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Drug reaction with eosinophilia and systemic symptoms (DRESS) in children.儿童药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）

本文引用的文献

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Vancomycin revisited - 60 years later.万古霉素再评价——60 年后。
Front Public Health. 2014 Oct 31;2:217. doi: 10.3389/fpubh.2014.00217. eCollection 2014.
2
Stevens-Johnson syndrome induced by the cross-reactivity between teicoplanin and vancomycin.替考拉宁与万古霉素交叉反应诱发的史蒂文斯-约翰逊综合征。
J Clin Pharm Ther. 2014 Aug;39(4):442-5. doi: 10.1111/jcpt.12159. Epub 2014 Apr 10.
3
In vitro drug causality assessment in Stevens-Johnson syndrome - alternatives for lymphocyte transformation test.史蒂文斯-约翰逊综合征的体外药物因果关系评估-淋巴细胞转化试验的替代方法。
Acta Biomed. 2019 Jan 29;90(3-S):66-79. doi: 10.23750/abm.v90i3-S.8167.
4
Clinical features, outcomes and treatment in children with drug induced Stevens-Johnson syndrome and toxic epidermal necrolysis.药物性史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症患儿的临床特征、结局及治疗
Acta Biomed. 2019 Jan 29;90(3-S):52-60. doi: 10.23750/abm.v90i3-S.8165.
Clin Exp Allergy. 2013 Sep;43(9):1027-37. doi: 10.1111/cea.12145.
4
Rapid immunochromatographic test for serum granulysin is useful for the prediction of Stevens-Johnson syndrome and toxic epidermal necrolysis.血清颗粒酶的快速免疫层析试验有助于预测史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症。
J Am Acad Dermatol. 2011 Jul;65(1):65-8. doi: 10.1016/j.jaad.2010.04.042. Epub 2011 Apr 19.
5
Carbamazepine-induced toxic effects and HLA-B*1502 screening in Taiwan.台湾的卡马西平诱导的毒性作用和 HLA-B*1502 筛查。
N Engl J Med. 2011 Mar 24;364(12):1126-33. doi: 10.1056/NEJMoa1009717.
6
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Pediatrics. 2009 Feb;123(2):e297-304. doi: 10.1542/peds.2008-1923. Epub 2009 Jan 19.
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Granulysin is a key mediator for disseminated keratinocyte death in Stevens-Johnson syndrome and toxic epidermal necrolysis.颗粒溶素是史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症中弥漫性角质形成细胞死亡的关键介质。
Nat Med. 2008 Dec;14(12):1343-50. doi: 10.1038/nm.1884. Epub 2008 Nov 23.
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HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol.HLA - B*5801等位基因作为别嘌醇引起严重皮肤不良反应的遗传标志物。
Proc Natl Acad Sci U S A. 2005 Mar 15;102(11):4134-9. doi: 10.1073/pnas.0409500102. Epub 2005 Mar 2.