高龄患者应用地塞米松磷酸钠致精神异常1例

A case of psychiatric disorder due to dexamethasone sodium phosphate in an elderly patient

1例104a男性患者,因老年性类天疱疮给予人免疫球蛋白治疗,并于给药前静脉滴注地塞米松磷酸钠预防过敏反应。3d后患者出现精神亢奋、言语多、思维活跃、肢体动作多,主诉难以入睡、多梦。第4天,将地塞米松磷酸钠改为盐酸异丙嗪,5d后兴奋状态消失。2个月后患者老年性类天疱疮复发,此次用盐酸异丙嗪预防人免疫球蛋白过敏反应,未出现精神亢奋等症状。

A 104-year-old male patient with senile pemphigoid was given dexamethasone sodium phosphate by intravenous infusion before immunoglobulin treatment in order to prevent allergic reaction.Three days later,he complained of insomnia,dreaminess accompanying with mental excitement,more speech and active thinking,more limb movements.Then he was given promethazine hydrochloride instead of dexamethasone the next day.Those symptoms of psychiatric disorder disappeared five days later.Two months later,the senile pemphigoid relapsed.This time,he received promethazine hydrochloride rather than dexamethasone to prevent the allergic reaction induced by immunoglobulin,and the mental symptoms had never appeared.