Abstract:Objective: To investigate the suspicious drugs and pharmacoepidemiologic features of drug-induced hypersensitivity syndrome (DHS). Methods: 35 cases of drug hypersensitivity syndrome were collected, clinical data were collected and analyzed retrospectively, suspicious drugs were finded and epidemiological characteristics were analyzed. Results: ① Of the 35 cases of DHS association results, 6 cases (17.14%) were confirmed (≥9 points), 19 cases (54.29%) were likely (5 to 8 points), 10 cases (28.57%) were possible (4 points). There was a strong correlation between most of the DHS and suspicious drugs, Suspicious drugs were purine tablets (20 cases,60.00%), antiepileptic drugs (6 cases,17.14%), anti-tuberculosis drugs (5 cases,14.29%), non-steroidal anti-inflammatory drugs (4 cases,11.43%); In terms of disease outcome, after a comprehensive treatment, 91.43% (32/35) of the patients' condition were significantly improved and they all discharged, 8.57% (3/35) of patients died due to multiple organ failure. Fever or rash was the first symptom of most DHS, followed by typical clinical manifestations of DHS, such as oral, mucous membrane, genital damage, liver and kidney function damage, lymphadenopathy, pneumonia and so on. ② The most involved organs by DHS was the skin and its accessories (30.60%), followed by oral system (18.03%), digestive system (13.66%) and nervous system (13.66%), blood, immune, urinary and respiratory system less involved. Conclusion: DHS should be on the alert when the patient showed high fever, rash and visceral damage, the general anti-infective treatment is invalid, and they are with allopurine tablets, anti-TB drugs, antiepileptic drugs and other medication history.
徐霄. 药物超敏反应综合征的可疑药物及药物流行病学特征分析[J]. 河北医学, 2017, 23(11): 1901-1904.
XU Xiao. Analysis of Epidemiological Characteristics of Suspected Drug and Drug Hypersensitivity Syndrome. HeBei Med, 2017, 23(11): 1901-1904.
[1] 徐薇,杨菲菲,李邻峰.拉莫三嗪致药物超敏反应综合征病例分析[J].中国临床医生杂志,2017,45(1):117~118. [2] Descamps V. Human herpesvirus 6 involvement in paediatric drug hypersensitivity syndrome[J].Br Dermatol,2015,172(4):858~859. [3] Huo Z F, Chen C L, Liu P, et al. Analysis of related factors on effects of uterine artery embolization in the treatment of dysmenorrhea of adenomyosis and the construction and validation of prediction model[J].Zhonghua Fu Chan Ke Za Zhi,2016,51(9):650~656. [4] Ben-Said B, Arnaud-Butel S, Rozieres A, et al. Allergic delayed drug hypersensitivity is more frequently diagnosed in drug reaction, eosinophilia and systemic symptoms (DRESS) syndrome than in exanthema induced by beta-lactam antibiotics[J].Dermatol Sci,2015,80(1):71~74. [5] 赵琨,郑韩燕,刘琳,等.1例高龄女性别嘌呤醇致重症药疹患者的护理案例分析[J].实用临床医药杂志,2013,17(22):206~207. [6] Wouters M M, Balemans D, Van Wanrooy S, et al. Histamine receptor H1-mediated sensitization of TRPV1 mediates visceral hypersensitivity and symptoms in patients with irritable bowel syndrome[J].Gastroenterology,2016,150(4):875~887. [7] 吴小梅,蔡颖,刘巍.抗结核药物致超敏反应综合征17例[J].四川医学,2015(11):1581~1583. [8] Komatsu-Fujii T, Ohta M, Niihara H, et al. Usefulness of rapid measurement of serum thymus and activation-regulated chemokine level in diagnosing drug-induced hypersensitivity syndrome[J].Allergol Int,2015,64(4):388~389. [9] Kinoshita Y, Saeki H, Asahina A, et al. Drug-induced hypersensitivity syndrome in Japan in the past 10 years based on data from the relief system of the Pharmaceuticals and Medical Devices Agency[J].Allergol Int,2017,66(2):363~365. [10] 沈平,林元龙.17例别嘌呤醇所致药疹合并肾损害回顾性临床分析[J].实用临床医药杂志,2010,14(23):109. [11] Hagihara M, Yamagishi Y, Hirai J, et al. Drug-induced hypersensitivity syndrome by liposomal amphotericin-B: a case report[J].BMC Res Notes,2015,8:510. [12] 刘毅. 抗癫痫类药物致药物超敏反应综合征的文献分析[J].现代药物与临床,2016,31(12):2064~2066. [13] Kounis N G, Koniari I, Roumeliotis A, et al. Thrombotic responses to coronary stents, bioresorbable scaffolds and the Kounis hypersensitivity-associated acute thrombotic syndrome[J].Thorac Dis,2017,9(4):1155~1164.