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系统性红斑狼疮患者霉酚酸酯引起的皮肤不良反应:一例报告

Adverse Dermatological Reaction to Mycophenolate Mofetil in a Patient with Systemic Lupus Erythematosus: A Case Report.

作者信息

Cao Yuxin, Chen Haijuan, Liao Zhimei, Xiang Hui, Zhang Xia, Di Xiaorong, Tang Wei, Ding Li, Liao Lianming

机构信息

Department of Rheumatology and Immunology, People's Hospital of Changji Hui Autonomous Prefecture, Changji, Xinjiang, China.

Department of Rheumatology and Immunology, People's Hospital of Changji Hui Autonomous Prefectur, Changji, Xinjiang, China.

出版信息

Am J Case Rep. 2025 Sep 9;26:e948698. doi: 10.12659/AJCR.948698.

Abstract

BACKGROUND Mycophenolate mofetil (MMF) is a disease-modifying antirheumatic drug (DMARD) that has been reported to cause skin rashes. Systemic lupus erythematosus (SLE) is also associated with typical discoid skin lesions. This report describes the case of a 50-year-old woman with a 6-year history of SLE presenting with a 6-day history of fever and skin rash after starting treatment with MMF. CASE REPORT The patient was admitted to the hospital due to fever. Due to intolerance to cyclosporine treatment and non-compliance with treatment for half a year, the doctor determined that her SLE was active and prescribed MMF. After receiving MMF treatment, she suddenly developed drug-induced dermatitis, characterized by fever, nausea, vomiting, and diffuse erythematous rash. After stopping MMF and treating with corticosteroids and antihistamines for 8 days, her symptoms rapidly resolved. When MMF treatment was restarted, the same symptoms and rash reappeared. The fever and vomiting disappeared 1 day after drug withdrawal, confirming the association between the drug and adverse reactions. No recurrence of the rashes was observed at 2-month follow-up. CONCLUSIONS This report highlights an uncommon adverse effect of MMF and describes the onset and characteristics of the associated drug-induced dermatosis. Early identification and discontinuation of MMF are crucial for managing these adverse events and preventing long-term complications.

摘要

背景

霉酚酸酯(MMF)是一种改善病情抗风湿药(DMARD),据报道可引起皮疹。系统性红斑狼疮(SLE)也与典型的盘状皮肤病变有关。本报告描述了一名50岁女性的病例,该患者有6年SLE病史,在开始使用MMF治疗后出现了6天的发热和皮疹病史。病例报告:患者因发热入院。由于对环孢素治疗不耐受且半年未遵医嘱治疗,医生判定其SLE处于活动期并开具了MMF。接受MMF治疗后,她突然出现药物性皮炎,表现为发热、恶心、呕吐和弥漫性红斑疹。停用MMF并用糖皮质激素和抗组胺药治疗8天后,她的症状迅速缓解。当重新开始MMF治疗时,相同的症状和皮疹再次出现。停药1天后发热和呕吐消失,证实了药物与不良反应之间的关联。在2个月的随访中未观察到皮疹复发。结论:本报告强调了MMF一种罕见的不良反应,并描述了相关药物性皮肤病的发病情况和特征。早期识别并停用MMF对于处理这些不良事件和预防长期并发症至关重要。

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