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当自身免疫“盛装打扮”时:一例赛妥珠单抗治疗后的病例

When Autoimmunity 'DRESSes up': A Case after Certolizumab Therapy.

作者信息

Marigliano Benedetta, Rosa Federico, Internullo Mattia, Scuro Luigi, Tavanti Andrea, Del Vecchio Lucia Rita, Romagno Francesco Paolo, Schito Maria Barbara, Pace Federica, Colombo Giovanni Maria, Guglielmelli Emanuele

机构信息

UOC Pronto Soccorso e Medicina d'Urgenza, Azienda Ospedaliera San Camillo - Forlanini, Rome, Italy.

UOC Pronto Soccorso e Medicina d'Urgenza, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

出版信息

Eur J Case Rep Intern Med. 2022 Jul 14;9(7):003451. doi: 10.12890/2022_003451. eCollection 2022.

DOI:10.12890/2022_003451
PMID:36051169
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9426962/
Abstract

UNLABELLED

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is characterised by skin rash together with visceral organ involvement, lymphadenopathy, eosinophilia and atypical lymphocytosis. The syndrome is clinically heterogeneous, making diagnosis challenging. It has an annual incidence of 2 per 100,000 population and a mortality rate of 2-10%. We describe the first case of DRESS induced by certolizumab, a biologic disease-modifying antirheumatic drug (bioDMARD).

LEARNING POINTS

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is an uncommon and under-reported syndrome.Its recognition is critical for treatment, especially in the emergency setting where most patients first present.In the case of unexplained fever, lymphadenopathy, cutaneous rash and characteristic laboratory findings (e.g., eosinophilia), after infectious causes have been ruled out, clinicians should always keep DRESS in mind and consider possible recent intake of a triggering drug.

摘要

未标注

药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS)的特征为皮疹伴内脏器官受累、淋巴结病、嗜酸性粒细胞增多和非典型淋巴细胞增多。该综合征在临床上具有异质性,诊断具有挑战性。其年发病率为每10万人中有2例,死亡率为2%至10%。我们报告了第一例由赛妥珠单抗(一种生物改善病情抗风湿药)诱发的DRESS病例。

学习要点

药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS)是一种罕见且报告不足的综合征。认识到这一点对治疗至关重要,尤其是在大多数患者首次就诊的急诊环境中。对于不明原因的发热、淋巴结病、皮疹和特征性实验室检查结果(如嗜酸性粒细胞增多),在排除感染原因后,临床医生应始终牢记DRESS,并考虑近期可能摄入的触发药物。

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本文引用的文献

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A Novel Treatment for a Rare Cause of Cardiogenic Shock.一种针对心源性休克罕见病因的新型治疗方法。
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Drug reaction with eosinophilia and systemic symptoms (DRESS) successfully treated with tumor necrosis factor-α inhibitor.使用肿瘤坏死因子-α抑制剂成功治疗的伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS)。
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Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): An Interplay among Drugs, Viruses, and Immune System.药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS):药物、病毒与免疫系统之间的相互作用
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Drug reaction with eosinophilia and systemic symptoms (DRESS): incidence, pathogenesis and management.药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS):发病率、发病机制及管理
Expert Opin Drug Saf. 2017 Feb;16(2):139-147. doi: 10.1080/14740338.2017.1270940. Epub 2016 Dec 21.
7
Drug-induced hypereosinophilia related to tocilizumab therapy for rheumatoid arthritis.与托珠单抗治疗类风湿关节炎相关的药物性嗜酸性粒细胞增多症
Rheumatology (Oxford). 2015 Nov;54(11):2113-4. doi: 10.1093/rheumatology/kev275. Epub 2015 Jul 29.
8
Liver injury in patients with DRESS: A clinical study of 72 cases.药物反应伴嗜酸性粒细胞增多和系统症状(DRESS)患者的肝损伤:72 例临床研究。
J Am Acad Dermatol. 2015 Jun;72(6):984-91. doi: 10.1016/j.jaad.2015.02.1130. Epub 2015 Mar 20.
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Prolonged evolution of drug reaction with eosinophilia and systemic symptoms: clinical, virologic, and biological features.伴有嗜酸性粒细胞增多和全身症状的药物反应的长期演变:临床、病毒学和生物学特征
JAMA Dermatol. 2014 Feb;150(2):206-7. doi: 10.1001/jamadermatol.2013.6698.
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Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adverse drug reaction. Results from the prospective RegiSCAR study.药物反应伴嗜酸性粒细胞增多和全身症状(DRESS):一种原始的多系统药物不良反应。来自前瞻性 RegiSCAR 研究的结果。
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