Literature Analysis of Hemophagocytic Lymphohistiocytosis Induced by Antiepileptic Drugs

DING Ling; LIU Lihua; LUO Xing; DUAN Xianlai; HUANG Fang; TANG Xianjing; QIU Ke; BI Fangfang

doi:10.14009/j.issn.1672-2124.2023.02.025

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Literature Analysis of Hemophagocytic Lymphohistiocytosis Induced by Antiepileptic Drugs

更新时间：2023-04-14

- Literature Analysis of Hemophagocytic Lymphohistiocytosis Induced by Antiepileptic Drugs
- Issue 2, Pages: 245-249(2023)
- 作者机构：
  
  1. 长沙市第三医院神经内科长沙市血管病防治研究所
  2. 长沙市第三医院药学部
  3. 中南大学湘雅医院神经内科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2023.02.025
  CLC： R971.6;{G353}
- Published：2023，
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DING Ling, LIU Lihua, LUO Xing, et al. Literature Analysis of Hemophagocytic Lymphohistiocytosis Induced by Antiepileptic Drugs. [J]. (2):245-249(2023)
DOI：

DING Ling, LIU Lihua, LUO Xing, et al. Literature Analysis of Hemophagocytic Lymphohistiocytosis Induced by Antiepileptic Drugs. [J]. (2):245-249(2023) DOI： 10.14009/j.issn.1672-2124.2023.02.025.

摘要

目的：了解抗癫痫药相关噬血细胞性淋巴组织细胞增生症（HLH）的临床特点。方法：检索PubMed、OVID、Embase、中国知网、万方数据库和维普数据库（截至2022年3月）

收集抗癫痫药相关HLH的个案报道类文献，记录患者基本情况（年龄、性别和原发病等）、致敏药物、用药剂量和联合用药，以及HLH发生时间、临床表现、处置和转归等信息，进行描述性统计分析。结果：共收集个案报道类文献20篇，涉及22例患者，其中男性14例，女性8例；年龄3～59岁；应用拉莫三嗪18例，苯巴比妥2例，奥卡西平1例，同时使用卡马西平、苯妥英和托吡酯1例；17例报告了出现HLH的时间，HLH发生时间最短和最长的药品均为拉莫三嗪，分别为用药后第6日和第42日。抗癫痫药致HLH的典型临床表现主要为发热、皮疹及多脏器损害。停用抗癫痫药并使用糖皮质激素、依托泊苷、免疫球蛋白等治疗，19例患者的症状在数日至数月内逐渐改善，3例患者最终死亡。结论：应关注抗癫痫药所致HLH

加强用药教育，早期识别和停止使用致敏药物，结合相关治疗患者症状可改善，但严重者可致死亡。

Abstract

OBJECTIVE: To investigate the clinical characteristics of hemophagocytic lymphohistiocytosis（HLH） induced by antiepileptic drugs. METHODS: PubMed

OVID

Embase

CNKI

Wanfang Data and VIP（up to Mar. 2022） were retrieved to collect the case reports on HLH induced by antiepileptic drugs

and the basic information of patients（age

gender

primary disease）

sensitized antiepileptic drugs

drug doses and drug combination were recorded. Descriptive statistical analysis was performed on occurrence time

clinical manifestations

treatment and outcomes of HLH. RESULTS: A total of 20 case reports of 22 patients were collected

including 14 males and 8 females. Age ranged from 3 to 59 years old. Among them

18 cases were treated with lamotrigine

2 cases with phenobarbital

1 case with oxcarbazepine

and 1 case with carbamazepine

phenytoin and topiramate. There were 17 cases mentioned the time of HLH

the shortest and longest time were lamotrigine

which was the 6th and 42nd days after treatment

respectively. The typical clinical manifestations of HLH induced by antiepileptic drugs were fever

rash and multiple organ damage. After stopping antiepileptic drugs and using glucocorticoids

etoposide

immune globulin

the symptoms of 19 patients were improved within a few days to several months

and 3 patients died. CONCLUSIONS: Attention should be paid to HLH induced by antiepileptic drugs

drug education should be strengthened

early identification and discontinuation of sensitized antiepileptic drugs. Combined with relevant treatment

the symptoms of patients can be improved

yet severe cases can lead to death.

关键词

抗癫痫药噬血细胞综合征噬血细胞性淋巴组织细胞增生症药品不良反应

Keywords

Antiepileptic drugsHemophagocytic syndromeHemophagocytic lymphohistiocytosisAdverse drug reactions

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