Unit of Allergy, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.
Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
Minerva Pediatr (Torino). 2023 Apr;75(2):296-298. doi: 10.23736/S2724-5276.22.07044-6. Epub 2022 Nov 2.
Black tongue (BT) is a benign, self-limiting black discoloration of the lingual mucosa due to different factors. Only a few pediatric cases of BT related to drug intake are described. We report a child with BT developed after amoxicillin/clavulanic acid intake and also made a review of the pediatric cases of black tongue reported in literature after drugs. The child underwent allergy work-up with in-vivo and in-vitro tests, showing a positive lymphocyte transformation test (LTT) for amoxicillin and amoxicillin/clavulanic acid. For the first time, BT was proved to be a hypersensitivity reaction to drugs, suggesting a possible role of a T-cell mediated mechanism. Even if already reported as a mild side effect, according to our results, allergy investigations are essential to make a confident diagnosis and to give further indications to patients about the discontinuation of the culprit drug.
黑舌（BT）是一种良性、自限性的舌黏膜黑色变色，由不同的因素引起。仅描述了少数与药物摄入有关的儿科 BT 病例。我们报告了一例因阿莫西林/克拉维酸摄入而发生的 BT 患儿，并对文献中报道的药物相关儿科黑舌病例进行了回顾。患儿进行了过敏检测，包括体内和体外试验，结果显示对阿莫西林和阿莫西林/克拉维酸的淋巴细胞转化试验（LTT）阳性。BT 首次被证明是一种药物超敏反应，提示可能存在 T 细胞介导的机制。尽管已经报道为一种轻微的副作用，但根据我们的结果，过敏检测对于做出明确的诊断和向患者进一步说明停止使用致病药物是必要的。
