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儿童拉莫三嗪诱发的药物超敏反应伴嗜酸性粒细胞增多和系统症状综合征:一例报告及文献综述

Lamotrigine Induced DRESS Syndrome in a Child: A Case Report and Literature Review.

作者信息

Lin Chien-Heng, Lin Sheng-Shing, Hong Syuan-Yu, Chen Chieh-Ho, Chou I-Ching

机构信息

Division of Pediatric Pulmonology, China Medical University Children's Hospital, Taichung 404327, Taiwan.

Department of Biomedical Imaging and Radiological Science, College of Medicine, China Medical University, Taichung 404328, Taiwan.

出版信息

Children (Basel). 2021 Nov 19;8(11):1063. doi: 10.3390/children8111063.

DOI:10.3390/children8111063
PMID:34828776
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8624037/
Abstract

Lamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as a drug reaction with eosinophilia and systemic symptoms (DRESS). Here, we report the case of a 7-year-6-month-old girl with a history of epilepsy who developed a skin rash with dyspnoea after 2 weeks of lamotrigine treatment, with DRESS ultimately being diagnosed. After discontinuation of the offending drug and the initiation of systemic glucocorticosteroids, the DRESS symptoms were relieved and the patient was discharged in a stable condition. Anticonvulsant drugs such as lamotrigine are among the factors that induce DRESS in children. When a patient displays skin rash and systemic organ involvement following the initiation of an anticonvulsant drug, DRESS should not be overlooked as a diagnosis, and immunosuppressant drugs should be considered as an option for treating DRESS patients.

摘要

拉莫三嗪是一种重要的抗惊厥药物。然而,其使用受到潜在危及生命的皮肤反应风险的限制,例如伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS)。在此,我们报告一例7岁6个月大的癫痫女童病例,该女童在拉莫三嗪治疗2周后出现皮疹并伴有呼吸困难,最终被诊断为DRESS。停用致病药物并开始使用全身性糖皮质激素后,DRESS症状得到缓解,患者病情稳定出院。拉莫三嗪等抗惊厥药物是诱发儿童DRESS的因素之一。当患者在开始使用抗惊厥药物后出现皮疹和全身器官受累时,不应忽视DRESS这一诊断,免疫抑制药物应被视为治疗DRESS患者的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4723/8624037/9bd6aca8c772/children-08-01063-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4723/8624037/9bd6aca8c772/children-08-01063-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4723/8624037/9bd6aca8c772/children-08-01063-g001.jpg

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Less Known Gastrointestinal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of the Literature.药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS)综合征鲜为人知的胃肠道表现:文献系统综述
J Clin Med. 2021 Sep 21;10(18):4287. doi: 10.3390/jcm10184287.
2
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Associated with Infection.药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS)与感染相关。
Case Rep Dermatol. 2020 Nov 12;12(3):225-230. doi: 10.1159/000510706. eCollection 2020 Sep-Dec.
3
Pulmonary Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review.
药物反应伴嗜酸性粒细胞增多和全身症状(DRESS)综合征的肺部表现:系统评价。
Biomed Res Int. 2019 Sep 24;2019:7863815. doi: 10.1155/2019/7863815. eCollection 2019.
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Drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS): An update in 2019.药物诱导的超敏反应综合征(DiHS)/伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS):2019 年的更新。
Allergol Int. 2019 Jul;68(3):301-308. doi: 10.1016/j.alit.2019.03.006. Epub 2019 Apr 16.
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J Am Acad Dermatol. 2019 Mar;80(3):670-678.e2. doi: 10.1016/j.jaad.2018.08.052. Epub 2018 Sep 18.
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Intern Med. 2016;55(13):1769-74. doi: 10.2169/internalmedicine.55.6287. Epub 2016 Jul 1.
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