碘造影剂所致的药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）综合征。一例病例报告。
DRESS syndrome due to iodinated contrast media. A case report.
作者信息
Zambrano Ibarra G, Noguerado Mellado B, Tornero Molina P, Cuevas Bravo C, Rojas Pérez-Esquerra P
机构信息
Allergy Department, Hospital General Universitario Gregorio Marañón, Calle Dr. Esquerdo 46, 28007, Madrid, Spain.
出版信息
Allergy Asthma Clin Immunol. 2023 Feb 27;19(1):16. doi: 10.1186/s13223-023-00774-7.
BACKGROUND
The most frequent non-immediate reactions described with iodinated contrast media (ICM) are mild to moderate, however, some cases of patients with severe non-immediate reactions, such as drug eruption with eosinophilia and systemic symptoms (DRESS) have been described.
CASE PRESENTATION
An 84-year-old patient developed DRESS syndrome after administration of ICM ioversol. The patient fullfilled the RegiSCAR diagnostic criteria for DRESS (definite score = 6). He underwent intradermal skin testing (IDT) with the widest panel of ICM available at our center. IDT was positive with ioversol and iomeprol. A punch biopsy was performed on the positive IDT with the culprit drug (ioversol) and histopathology was compatible with a T-cell mediated mechanism.
CONCLUSION
In this case, the IDT-positive biopsy was consistent with DRESS syndrome caused by T-lymphocyte activation, supporting the clinical diagnosis.
背景
使用碘化造影剂（ICM）后描述的最常见的非即时反应为轻至中度，然而，也有一些严重非即时反应患者的病例报道，如药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）。
病例报告
一名84岁患者在使用ICM碘克沙醇后发生DRESS综合征。该患者符合RegiSCAR DRESS诊断标准（确诊分数=6）。他接受了我们中心提供的最广泛的ICM皮内皮肤试验（IDT）。碘克沙醇和碘美普尔的IDT呈阳性。对用致病药物（碘克沙醇）进行的阳性IDT部位进行了打孔活检，组织病理学与T细胞介导机制相符。
结论
在本病例中，IDT阳性活检结果与T淋巴细胞活化引起的DRESS综合征一致，支持临床诊断。
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