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一例特殊病例分析:拉莫三嗪相关的史蒂文斯-约翰逊综合征

A Singular Case Analysis: Lamotrigine-Associated Stevens-Johnson Syndrome.

作者信息

Joshi Albin, Palikhe Anjula, Acharya Santosh, Kunwor Puskar

机构信息

Department of Pharmacy, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal.

Department of Critical Care, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal.

出版信息

Case Rep Crit Care. 2024 Nov 26;2024:4835223. doi: 10.1155/crcc/4835223. eCollection 2024.

Abstract

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) is an immune complex-mediated hypersensitivity reaction linked as an adverse side effect to many drugs. There have been case reports of similar incidences in Nepal related to various medications. Here, we present a case of a 29-year-old lady who developed a generalized erythematous rash over her body and erosion of the oral mucous membrane. Two weeks back she gave a history of initiation of lamotrigine, olanzapine, and sertraline. Given the strong association between SJS and lamotrigine, and the usual presentation being within the first 8 weeks of exposure to susceptible medications; she was diagnosed as SJS/TEN induced by lamotrigine. On April 1, 2024, she was admitted to the ICU at KIST MCTH. All the medicines were withheld, and she was managed with corticosteroids and antihistamines. She improved significantly within 7 days. Early identification of SJS, discontinuation of triggering medicines, and prompt initiation of supportive therapy improved the prognosis.

摘要

史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症(SJS/TEN)是一种免疫复合物介导的超敏反应,与许多药物的不良反应有关。在尼泊尔有关于各种药物引发类似发病率的病例报告。在此,我们报告一例29岁女性病例,该患者全身出现泛发性红斑疹,口腔黏膜糜烂。两周前,她有开始服用拉莫三嗪、奥氮平和舍曲林的病史。鉴于SJS与拉莫三嗪之间的密切关联,且通常在接触易感药物的前8周内出现症状;她被诊断为拉莫三嗪诱发的SJS/TEN。2024年4月1日,她入住基斯特医学院教学医院重症监护病房。停用了所有药物,并给予她皮质类固醇和抗组胺药进行治疗。她在7天内有显著改善。早期识别SJS、停用引发药物并及时开始支持性治疗可改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffb0/11614506/df579d5ce093/CRICC2024-4835223.001.jpg

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