甘草酸二铵注射液致湿疹样疹

Eczematid caused by intravenous infusion of diammonium glycyrrhizinate

1例24岁男性症状性癫痫患者间断服用丙戊酸钠16年。入院时,患者肝功能为ALT41U/L,AST56U/L。患者在行癫痫病灶切除术后9d,ALT和AST水平分别升至224U/L和99U/L。给予甘草酸二铵150mg加入5%葡萄糖注射液250ml中静脉滴注,1次/d。用药4d后,患者四肢出现对称性红斑、水疱伴瘙痒,之后累及颈部、腋窝、肘窝、腹股沟及腘窝,红斑中央有斑丘疹和丘疱疹,诊断为药物诱发的湿疹样疹。停用甘草酸二铵注射液,给予西替利嗪和维生素C治疗。3d后皮疹减少,瘙痒减轻。追问病史,患者在1年前曾因静脉滴注甘草酸二铵出现过全身红斑伴瘙痒。

A 24-year-old man with symptomatic epilepsy received an intermittent therapy of sodium valproate for 16 years. On admission, his ALT and AST levels were 41 U/L and 56 U/L, respectively. The patient~ ALT and AST levels increased to 224 U/L and 99 U/L respectively 9 days after undergoing epileptogenic focus resection. He was given an IV infusion of diammonium glycyrrhizinate 150 mg mixed with 5% Glucose injection 250 ml once daily. Four days later, the man developed bilateral erythema and blister with pruritus in his extremities. Subsequently, his erythema progressed to involve his neck, axillary fossa, cubital fossa, groin, and popliteal fossa. These lesions consisted of a central maculopapale and papulo-vesicle surround by erythematous ring. Drug-induced eezematid was diagnosed. Diammonium glyeyrrhizinate was stopped, and cetirizine and vitamin C were given. Three days later, skin eruption and pruritus subsided. According to his history, he experienced generalized erythema with pruritus after treatment of an Ⅳ infusion of diammonium glyeyrrhizinate one year ago.