Killik Petra, Kostyál Erika, Tóth Gábor, Szentmáry Nóra, Nagy Zoltán Zsolt, Maneschg Otto Alexander
1 Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika Budapest, Mária u. 39., 1085 Magyarország.
2 Bethesda Gyermekkórház, Égéssérült Gyermekeket Gyógyító Országos Központ, Aneszteziológiai és Intenzív Terápiás Osztály Budapest Magyarország.
Orv Hetil. 2024 Aug 4;165(31):1206-1212. doi: 10.1556/650.2024.33096.
Stevens–Johnson syndrome and toxic epidermal necrolysis are rare but very serious hypersensitivity reactions that cause skin and mucosal disorders, mainly caused by drugs or infectious agents. While this pathology is a potentially life-threatening condition, the ocular consequences should not be overlooked, which may effect the long-term quality of life of the individual. The aim of this case report is to raise awareness of the ophthalmological complications of these conditions and the importance of starting treatment as soon as possible. In the acute phase, 50% of patients present with ocular involvement, during which time the focus may be lost from ophthalmic intervention due to high mortality. In the following, we report the case of a 17-year-old patient in whom the use of lamotrigine induced toxic epidermal necrolysis. The first 4 weeks (54 days in total) were extremely critical. The full-body epidermolysis was associated with systemic complications such as hypothermia, acute respiratory distress syndrome, septicemia, acute tubular necrosis, anemia and severe electrolyte imbalances, which were successfully treated. The ophthalmological symptoms of the disease were well under control from the beginning and were treated intensively and regularly. After two years, there were no significant complications in the anterior segment of the eye, and the visual acuity was fully preserved. Orv Hetil. 2024; 165(31): 1206–1212.
史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症虽罕见但极为严重,是可引发皮肤和黏膜疾病的超敏反应,主要由药物或感染因素所致。尽管这种病症可能危及生命,但眼部后果不容小觑,其可能影响个体的长期生活质量。本病例报告旨在提高对这些病症眼部并发症的认识以及尽早开始治疗的重要性。在急性期,50%的患者会出现眼部受累,在此期间,由于高死亡率,眼科干预可能会被忽视。以下,我们报告一例17岁患者,其使用拉莫三嗪诱发了中毒性表皮坏死松解症。最初的4周(共计54天)极为关键。全身表皮松解伴有体温过低、急性呼吸窘迫综合征、败血症、急性肾小管坏死、贫血和严重电解质失衡等全身并发症,这些并发症均得到成功治疗。该疾病的眼科症状从一开始就得到了很好的控制,并得到了积极且规律的治疗。两年后,眼前节无明显并发症,视力完全保留。《匈牙利医学周报》。2024年;165(31): 1206–1212。