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1. 重庆医科大学附属第二医院神经内科
2. 重庆医科大学附属第二医院神经内科,重庆,400010
纸质出版日期:2006,
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[1]郑丽华,许静,陈阳美.抗癫痫药高敏综合征临床及病理分析[J].重庆医科大学学报,2006(02):259-261+279.
ZHENG Lihua, et al. Clinical and pathological analysis in one case of antiepileptic drug hypersensitivity syndrome[J]. Journal of Chongqing Medical University, 2006,(2):259-261.
目的:探讨抗癫痫药高敏综合征(AHS)的临床特点、诊断、发病机理及治疗。方法:回顾性分析1例经临床诊断的AHS患者的临床资料。结果:该例患者服用卡马西平后6w以发热起病
表现为典型的发热、皮疹、淋巴结病三联征
并合并肝、肺受累。血清免疫学、淋巴结活检及骨髓涂片结果提示该病例为免疫反应性增生
排除了其他类似表现的炎症性疾病及肿瘤。及时停用卡马西平
应用皮质激素治疗后病情迅速缓解。结论:AHS是一种特异质反应
与免疫状态密切相关
其发病机理尚未明确。临床表现和实验室检查是诊断及鉴别诊断的重要依据。即早认识并停用致敏药物是治疗的关键。
Objective: To discuss the clinical features
diagnosis
pathogenesis and treatment of antiepileptic drug hypersensitivity syndrome(AHS).Methods: A retrospective analysis of one case of AHS was focused on his clinical data.Results: About six weeks after carbamazepine treatment the patient presented fever firstly.The highest temperature is up to 39.6℃.Subsequently he developed diffusible red maculopapular rash and swollen superficial lymph nodes.Physical examination found internal organs involvement(mainly liver and lung).Laboratory examinations showed that the leucocyte increased to 54.21×109/L
and the percentage and absolute count of eosinophil rose
while IgG and IgM decreased.The CT of thoracic part showed the lymph nodes of hilum of lung and mediastina swelled together with pleural effusion.A biopsy study of lymph node suggested the reactive hyperplasia which was not equal to lymphoma.The bone marrow smear showed granulocytic cell line hyperplasia and abnormal lymphocyte were observed.After discontinuing carbamazepine in time and applying corticosteroids
the temperature descended rapidly and the swollen lymph nodes recovered soon.Conclusion: AHS is an idiosyncratic reaction.It usually occurs within 2 to 8 weeks after initiation of antiepileptic drug therapy
and typically manifests itself as fever
eruption and internal organ involvements.Pathogenesis is still not definite.Important basis for diagnosis and differential diagnosis depends on clinical manifestations and laboratory examinations.Early recognition of AHS and timely discontinuing of the suspected drugs are the essential therapy.
抗癫痫药药物过敏
AntiepilepticDrug hypersensitivity
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