一名14岁发热、皮疹、淋巴结病及全血细胞减少的女性：病例报告。

A 14-year-old female with fever, rash, lymphadenopathy, and pancytopenia: a case report.

作者信息

Varshochi Mojtaba, Ravanbakhsh Gavgani Reyhaneh, Naghili Behrooz, Bayatmakoo Zhinus, Poorshahverdi Parinaz, Ravanbakhsh Gavgani Fatemeh

机构信息

Department of Infectious Disease, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, 51666, Iran.

Department of Biological Sciences, School of Natural Sciences, University of Tabriz, Tabriz, Iran.

出版信息

J Med Case Rep. 2020 Jan 26;14(1):20. doi: 10.1186/s13256-019-2286-2.

DOI:10.1186/s13256-019-2286-2

PMID:31982029

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6983282/

Abstract

BACKGROUND

Anticonvulsant hypersensitivity syndrome is a rare adverse drug reaction associated with aromatic anticonvulsant drugs. This syndrome can range from mild cutaneous rash to drug reaction with eosinophilia and systemic symptoms that include fever, rash, lymphadenopathy, pancytopenia, and involvement of multiple internal organs. We aimed to report this case in the literature and make physicians aware of the uncommon symptoms of this syndrome when they prescribe antiepileptic medications in particular.

CASE PRESENTATION

A 14-year-old Middle Eastern female patient from Iran with free past medical and allergic history was admitted to hospital because of fever, rash, lymphadenopathy, and pancytopenia after taking anticonvulsants due to new-onset seizure. High fever and cutaneous rash along with lymphadenopathy following administration of anticonvulsant medications that could not be explained by other causes alerted the physician to the possibility of this syndrome. Our investigation revealed no further diagnosis and 1 week after discontinuation of the drugs, her symptoms were resolved. Anticonvulsant hypersensitivity syndrome is a diagnosis of exclusion and immediate discontinuation of the suspicious drugs is necessary. Hence, early recognition can prevent permanent multiorgan damage.

CONCLUSIONS

Chlorpheniramine as a simple treatment was provided for this syndrome.

摘要

背景

抗惊厥药物超敏反应综合征是一种与芳香族抗惊厥药物相关的罕见药物不良反应。该综合征的症状范围从轻度皮疹到伴有嗜酸性粒细胞增多和全身症状的药物反应，全身症状包括发热、皮疹、淋巴结病、全血细胞减少以及多个内脏器官受累。我们旨在将该病例报告于文献中，并让医生在开具抗癫痫药物时，尤其要注意该综合征的不常见症状。

病例介绍

一名来自伊朗的14岁中东女性患者，既往无病史及过敏史，因新发癫痫服用抗惊厥药物后出现发热、皮疹、淋巴结病和全血细胞减少而入院。服用抗惊厥药物后出现高热、皮疹及淋巴结病，且无法用其他原因解释，这使医生警惕该综合征的可能性。我们的检查未发现进一步诊断结果，停药1周后，她的症状得到缓解。抗惊厥药物超敏反应综合征是一种排除性诊断，必须立即停用可疑药物。因此，早期识别可预防永久性多器官损害。