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儿童因抗组胺药引起的药疹被误诊为慢性荨麻疹。

Drug eruption by antihistamine mistaken for chronic urticaria in a child.

作者信息

Lee Gun Moo, Chu Shou-Yu, Kang Sung Yeon, Kim Hyo-Bin, Park Jin-Sung, Kim Ja Kyoung

机构信息

Department of Pediatrics, Kangwon National University Hospital, chuncheon, Korea.

Department of Pediatrics, Inje Unversity Sanggye Paik Hospital, Seoul, Korea.

出版信息

Korean J Pediatr. 2019 Feb;62(2):75-78. doi: 10.3345/kjp.2018.06695. Epub 2018 Oct 30.

Abstract

Although rare, antihistamines can cause adverse effects, including drug-induced eruptions or anaphylaxis. A 4-year-old child visited the pediatric department of a hospital for skin eruptions after administration of antihistamines, (e.g., ucerax [hydroxyzine] or leptizine [levocetirizine]), for cholinergic rashes; he did not have pruritus. Skin prick, intradermal, and drug provocation tests were performed to determine the relationship between the antihistamines and eruptions. Levocetirizine induced wheals in the skin prick test and a rash in the oral drug provocation test. In contrast, ketotifen induced no reaction in the skin prick test but showed a positive reaction in the oral provocation test. Our case report highlights that children can experience the same types of adverse reactions as seen in adults, and cross-reactivity between various antihistamines can occur.

摘要

尽管罕见,但抗组胺药可引起不良反应,包括药物性皮疹或过敏反应。一名4岁儿童因胆碱能性皮疹服用抗组胺药(如优泽[羟嗪]或乐亦静[左西替利嗪])后出现皮肤皮疹,前往医院儿科就诊;他没有瘙痒症状。进行了皮肤点刺试验、皮内试验和药物激发试验,以确定抗组胺药与皮疹之间的关系。左西替利嗪在皮肤点刺试验中引起风团,在口服药物激发试验中引起皮疹。相比之下,酮替芬在皮肤点刺试验中未引起反应,但在口服激发试验中呈阳性反应。我们的病例报告强调,儿童可能会出现与成人相同类型的不良反应,并且各种抗组胺药之间可能会发生交叉反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4f4/6382964/c601f9abc18e/kjp-2018-06695f1.jpg

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