奥司他韦诱发史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症——病例报告
Oseltamivir induced Stevens-Johnson syndrome/toxic epidermal necrolysis-case report.
作者信息
Zuo Wei, Wen Li-Ping, Li Jun, Mei Dan, Fu Qiang, Zhang Bo
机构信息
Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing.
Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education", Yantai University, Yantai, China.
出版信息
Medicine (Baltimore). 2019 May;98(19):e15553. doi: 10.1097/MD.0000000000015553.
RATIONALE
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are 2 rare but life-threatening diseases characterized by detachment of epidermis, bullous skin lesions, and mucous membrane erosions. Drugs are highly suspected to be the causative agents. We report a case of SJS/TEN induced by oseltamivir, which is a very rare event.
PATIENT CONCERNS
A 9-year-old girl with upper respiratory tract infections presented with generalized maculopapular rash the second day after taking oseltamivir.
DIAGNOSIS
The diagnosis of SJS/TEN was made based on cytotoxic skin lesions and mucous membrane involvement.
INTERVENTIONS
After discontinuing of the drug and combination therapy of corticosteroid and human immunoglobulin initiation, the lesions were improved. Human leukocyte antigen (HLA) gene sequencing was done.
OUTCOMES
The girl was followed-up for 1 year. The skin and mucous membranes symptoms were relieved.
LESSONS
We report this case to attract attention to the rare but serious side effect of this antiviral drug.
理论依据
史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是两种罕见但危及生命的疾病，其特征为表皮剥脱、水疱性皮肤损害和黏膜糜烂。药物被高度怀疑为致病因素。我们报告一例由奥司他韦引起的SJS/TEN病例，这是非常罕见的事件。
患者情况
一名9岁上呼吸道感染女童在服用奥司他韦第二天出现全身性斑丘疹。
诊断
根据细胞毒性皮肤损害和黏膜受累情况诊断为SJS/TEN。
干预措施
停药并开始使用皮质类固醇和人免疫球蛋白联合治疗后，皮损有所改善。进行了人类白细胞抗原（HLA）基因测序。
结果
对该女童进行了1年的随访。皮肤和黏膜症状缓解。
经验教训
我们报告此病例以引起对这种抗病毒药物罕见但严重副作用的关注。
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