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尽管长期逐渐减少类固醇用量,但来氟米特仍反复诱发伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS)综合征:一例报告

Recurrent Leflunomide-Induced Drug Reaction With Eosinophilia and Systemic Symptom (DRESS) Syndrome Despite Prolonged Steroid Taper: A Case Report.

作者信息

Gayfield Scott, Busken Joshua, Mansur Sarmed

机构信息

Internal Medicine, The University of Toledo, Toledo, USA.

出版信息

Cureus. 2022 Sep 19;14(9):e29319. doi: 10.7759/cureus.29319. eCollection 2022 Sep.

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction characterized primarily by nonspecific systemic symptoms such as fever, a classical rash, and eosinophilia. While this is an adverse reaction more often related to medications such as anticonvulsants, many drugs have been reported to be implicated in this event. We report a case of a 35-year-old male who developed DRESS syndrome within one month of beginning leflunomide therapy. Despite treatment with a prolonged steroid taper, he developed a flare-up with transaminitis less than two months after his initial hospitalization. Our patient was managed with steroid pulse therapy and cyclosporine, which resulted in an improvement of symptoms and transaminitis. To our knowledge, only nine previous cases of leflunomide-induced DRESS syndrome have been previously reported.

摘要

药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS)是一种严重的药物不良反应,主要特征为非特异性全身症状,如发热、典型皮疹和嗜酸性粒细胞增多。虽然这种不良反应更常与抗惊厥药等药物有关,但据报道许多药物都可引发该反应。我们报告一例35岁男性患者,在开始使用来氟米特治疗后1个月内发生了DRESS综合征。尽管接受了长期逐渐减量的类固醇治疗,但在首次住院后不到两个月,他出现了转氨酶升高的病情复发。我们的患者接受了类固醇冲击疗法和环孢素治疗,症状和转氨酶升高情况均有所改善。据我们所知,此前仅报告过9例来氟米特诱发的DRESS综合征病例。

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本文引用的文献

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An Uncommon Presentation of DRESS Syndrome Secondary to Leflunomide Use: A Case Report.
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:2324709621997282. doi: 10.1177/2324709621997282.
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