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.
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.
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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