|
|
|
| Clinical Characteristics of Drug Hypersensitivity Syndrome in Children |
| LUO Yang-yang, SHU Ye, TANG Jian-ping, et al |
| Department of Dermatology, Hunan Children's Hospital, Changsha 410007, China |
|
|
|
|
Abstract 【Objective】 To investigate the clinical characteristics and prognosis of childhood patients with drug-induced hypersensitivity syndrome(DIHS). 【Methods】 The clinical data of 9 children with DIHS were retrospectively analyzed, including allergic drugs, clinical manifestations, laboratory examination, imaging examination, treatment and prognosis.【Results】 There were 4 males and 5 females, aged from 8 months to 10 years. Allergic antibiotics accounted for 44.4%, including 2 cases of mezlocillin sulbactam, 1 case of cefathiamidine and 1 case of fosfomycin; anticonvulsant drugs accounted for 33.4%, including carbamazepine in 3 cases; antipyretic drugs accounted for 22.2%, including ibuprofen in 2 cases; the incubation period was 20 (10~40) d. Course of disease from was 21 ds to 4 months, 6 cases showed exfoliative dermatitis, 5 cases with hepatomegaly, 8 cases with abnormal transaminase, 6 cases with myocardial injury, 5 cases with pneumonia, 2 cases with Epstein Barr virus infection and 1 case with cytomegalovirus infection. Among them, 8 cases were cured after symptomatic support treatment with intravenous hormone, gamma globulin, anti infection and fluid infusion, and 2 cases had two peaks in the treatment process One patient died of multiple organ failure and suspected hemophagocytic syndrome. 【Conclusion】 Antibiotics and anticonvulsant drugs are common in children with DIHS. Exfoliative dermatitis is the main manifestation of skin rash. Liver and myocardial damage often occur. For patients with chronic viral infection, we should be alert to the phenomenon of two peaks. Patients with rapid progress of disease can be complicated with Hemophilus syndrome.
|
|
Received: 23 May 2019
|
|
|
|
|
|
[1] Watanabe H. Recent advances in drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms[J].J Immunol Res,2018 ,2018:5163129.
[2] 罗鸯鸯,唐金玲,孙磊,等.儿童药物超敏反应综合征一例[J].中华皮肤科杂志,2017,50(11):838-841.
[3] Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist[J].Br J Dermatol,2007,156(3):609-611.
[4] 石平荣,李凯,段逸群,等.药物超敏反应综合征发病机制及治疗的研究进展[J].国际皮肤性病学杂志,2006,32(2):117-119.
[5] Cacoub P, Musette P, Descamps V, et al. The DRESS syndrome: a literaturereview[J].Am J Med,2011,124(7):588-597.
[6] Ebrahimpour S, Mohammadi M, Gholami K.Drug reaction with eosinophilia and systemic symptoms (dress) with teicoplanin: a case report[J].Drug Saf Case Rep,2017,4(1):1.
[7] Dar WR, Sofi N, Latief M,et al. Levetiracetam induced drug reaction with eosinophilia and systemic symptom syndrome[J].Indian J Dermatol,2016 ,61(2):235.
[8] Gamboa P, Sanz ML, Caballero MR, et al. The flow-cytometric determination of basophil activation induced by aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) is useful for in vitro diagnosis of the NSAID hypersensitivity syndrome[J].Clin Exp Allergy,2004 ,34(9):1448-1457.
[9] Um SJ, Lee SK, Kim YH, et al. Clinical features of drug induced hypersensitivity syndrome in 38 patients[J].J Investig Allergol Clin Immunol,2010,20(7):556-562.
[10] Avancini J, Maragno L, Santi CG, et al. Drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome: clinical features of 27 patients[J].Clin Exp Dermatol,2015,40(8):851-859.
[11] Chen CB, Abe R, Pan RY, et al. An updated review of the molecular mechanisms in drug hypersensitivity[J].J Immunol Res,2018 , 2018:6431694.
[12] 刘聪,许红梅,谭利平,等.儿童药物超敏反应综合征22例临床分析[J].临床儿科杂志,2017,35(7):522-524. |
|
|
|
2020, Vol. 37 
