Cheng Jie, Li Hui, Li Yan, Li Xiao, Wang Jianjun, Huang Xin, Cui XueYan
Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan, China.
Department of Clinical Pharmacy Laboratory, The First Affiliated Hospital of Baotou Medical College, Baotou, China.
Front Pharmacol. 2024 Aug 1;15:1433506. doi: 10.3389/fphar.2024.1433506. eCollection 2024.
Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare, life-threatening immunologic reactions. Previous relevant literature has provided limited information regarding this disease's genetic susceptibility and management principles.
This study aimed to describe a phenobarbital-induced TEN case report with and negative, . In addition, we revised the existing literature on phenobarbital-induced SJS/TEN to explore its clinical characteristics.
We describe a woman undergoing treatment with Phenobarbital for status epilepticus who developed classic cutaneous findings of TEN. A systematic search was conducted in the PubMed, Medline, WanFang, and CNKI databases from 1995 to 2023. The search terms used were "Stevens-Johnson Syndrome," "Toxic Epidermal Necrolysis," and "Phenobarbital."
We report a case of TEN resulting from phenobarbital; it tested negative for the and allele and / intermediate metabolism. Supportive treatment with steroids and antihistamines resulted in complete resolution of the skin lesions and improvement in clinical symptoms after 14 days. Physicians and clinical pharmacists should be aware of these potential phenobarbital-related adverse events and closely monitor patients with first-time use of phenobarbital. Among 19 cases were identified in the literature, with 11 (57.9%) cases of SJS, 6 (31.6%) cases of TEN, and 2 (7.2%) cases of SJS-TEN/DRESS overlap. A total of 5 (26.3%) did not survive, of which 4 (21.1%) were under 12 years old and 1 (5.3%) was over 12 years old.
Phenobarbital-induced SJS/TEN may still occur in patients who test negative for and /. Most cutaneous adverse events occur early in the course of Phenobarbital therapy and should be closely monitored early in the course of treatment. In addition, Phenobarbital should be used with caution in patients with a history of asthma and allergy to antipyretics and analgesics.
中毒性表皮坏死松解症（TEN）和史蒂文斯-约翰逊综合征（SJS）是罕见的、危及生命的免疫反应。先前的相关文献提供了关于该疾病遗传易感性和治疗原则的有限信息。
本研究旨在描述一例苯巴比妥诱发的TEN病例报告，该病例 和 阴性， 。此外，我们对现有的关于苯巴比妥诱发的SJS/TEN的文献进行了修订，以探讨其临床特征。
我们描述了一名因癫痫持续状态接受苯巴比妥治疗的女性，她出现了典型的TEN皮肤表现。在1995年至2023年期间，在PubMed、Medline、万方和知网数据库中进行了系统检索。使用的检索词为“史蒂文斯-约翰逊综合征”、“中毒性表皮坏死松解症”和“苯巴比妥”。
我们报告一例由苯巴比妥引起的TEN病例；该病例 和 等位基因检测为阴性，且为 / 中间代谢型。使用类固醇和抗组胺药进行支持治疗后，皮肤病变在14天后完全消退，临床症状改善。医生和临床药师应意识到这些潜在的与苯巴比妥相关的不良事件，并在首次使用苯巴比妥时密切监测患者。在文献中鉴定出19例病例，其中11例（57.9%）为SJS，6例（31.6%）为TEN，2例（7.2%）为SJS-TEN/DRESS重叠综合征。共有5例（26.3%）未存活下来，其中4例（21.1%）年龄在12岁以下，1例（5.3%）年龄在12岁以上。
和 / 检测为阴性的患者仍可能发生苯巴比妥诱发的SJS/TEN。大多数皮肤不良事件发生在苯巴比妥治疗过程的早期，在治疗过程中应尽早密切监测。此外，有哮喘病史以及对抗生素和镇痛药过敏的患者应谨慎使用苯巴比妥。
