酚氨咖敏片致药物超敏反应综合征1例

One Case of Drug Induced Hypersensitivity Syndrome Due to Paracetamol,Aminophenazone, Caffeine and Chlorphenamine Maleate Tablets

1例43岁女性患者,因感冒口服酚氨咖敏片(1片tid),第2天停药。用药第5天出现四肢发疹,红斑伴瘙痒明显,第7天发展至面部,第9天出现高热。实验室检查示白细胞22.82×109/L,中性粒细胞百分率89.3%,丙氨酸氨基转移酶95 U·L-1,门冬氨酸氨基转移酶55 U·L-1。考虑为酚氨咖敏片致药物超敏反应综合征。给予注射用甲泼尼龙琥珀酸钠(80 mg qd)、复方甘草酸苷注射液(100 m L qd)静脉滴注,依巴斯汀片(10 mg qd)、盐酸赛庚啶片(2 mg qd)口服。第14天面部、躯干、四肢见暗红斑及色素沉着斑片,皮疹明显消退,实验室生化各项检查指标正常。

A 43-year-old female with influenza received paracetamol, aminophenazone, caffeine and chlorphenamine maleate tablets（1 tablet three times a day） and stopped medication on the second day. On day five after medication the patient developed papula, erythema accompanied by pruritus on her body and limbs. On day seven after medication the cases advanced to her face. On day nine, she got high fever.Laboratory tests revealed the following results： white blood cell（WBC） 22.82 ×109/L, percentage of eosinophils 2.7%, alanine aminotransferase（ALT） 95 U·L-1 and aspartate transaminase（AST） 55 U·L-1. She was diagnosed as drug hypersensitivity syndrome due to paracetamol, aminophenazone, caffeine and chlorphenamine maleate tablets. The patient received the treatments including IV infusion of methylprednisolone,compound glycyrrhizin injection, oral administration of ebastine tablets and cyproheptadine hydrochloride tablets. On day 14 of drug withdrawal, her facial oedema was subsided largely, the color of erythema changed to dark, and erythra decreased obviously and the laboratory indexes were normal.