Nousari H C, Kimyai-Asadi A, Caeiro J P, Anhalt G J
Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Medicine (Baltimore). 1999 Jan;78(1):1-8. doi: 10.1097/00005792-199901000-00001.
Administration of intravenous vancomycin has been associated with the development of linear IgA bullous disease (LABD). In contrast to the idiopathic variant, vancomycin-induced LABD (VILABD) appears to be more transient and to be associated with lower morbidity. The characteristics of this entity remain undefined. Our analysis of clinical, demographic, and immunopathologic features of 2 new and 14 previously reported patients with VILABD reveals that VILABD is clinically and immunopathologically indistinguishable from its idiopathic variant. A variety of premorbid conditions and concomitant medications were observed, none of which was consistently associated with the development of VILABD. VILABD occurs independently of vancomycin trough levels, resolves promptly upon discontinuation of vancomycin, and recurs more severely and with shorter onset latency with vancomycin rechallenge. This entity should be recognized as 1 of the adverse cutaneous effects of intravenous vancomycin, and warrants prompt diagnosis through direct immunofluorescence skin examination.
静脉注射万古霉素与线性IgA大疱性疾病（LABD）的发生有关。与特发性变体不同，万古霉素诱导的LABD（VILABD）似乎更具一过性，且发病率较低。该疾病实体的特征仍不明确。我们对2例新病例和14例先前报道的VILABD患者的临床、人口统计学和免疫病理学特征进行分析，结果显示VILABD在临床和免疫病理学上与其特发性变体无法区分。观察到多种病前状况和伴随用药情况，但均未与VILABD的发生始终相关。VILABD的发生与万古霉素谷浓度无关，停用万古霉素后迅速缓解，再次使用万古霉素时复发更严重且发病潜伏期更短。该疾病实体应被视为静脉注射万古霉素的不良皮肤效应之一，需要通过直接免疫荧光皮肤检查进行及时诊断。
