别嘌醇致抗中性粒细胞胞浆抗体相关性小血管炎肾损害患者药物超敏反应综合征的病例分析

Allopurinol-induced hypersensitivity syndrome in an anti-neutrophil cytoplasmic antibody-associated systemic vasculitis patient with renal injury

目的探讨临床药师参与抗中性粒细胞胞浆抗体(ANCA)相关性小血管炎肾损害患者使用别嘌醇引起的药物超敏反应综合征治疗的作用。方法临床药师参与1例别嘌醇致药物超敏反应综合征患者的治疗过程,对HLA-B~*58:01基因进行检测,提出药学建议,协助临床医师制定适宜的治疗方案。结果与结论针对肾功能不全患者应关注降尿酸药物的选择和剂量调整,针对使用别嘌醇患者开展HLA-B~*58:01基因检测有助于诊断和预防别嘌醇导致的严重皮肤药物不良反应。临床药师参与临床工作,通过药物基因检测可以辅助临床进行诊断和治疗决策,减少药物不良反应的发生。

Objective To explore the effect of clinical pharmacists taking part in the treatment of allopurinol-induced hypersensitivity syndrome in an anti-neutrophil cytoplasmic antibody（ ANCA）-associated systemic vasculitis（ AASV） patient with renal injury. Methods Clinical pharmacists took part in the therapy of a patient with allopurinol-induced hypersensitivity syndrome,testing HLA-B~＊ 58： 01 and giving therapy suggestion,thus giving assistance to the physiciansin appropriate treatment. Results and conclusion Urate-lowering agents for patients with renal insufficiency should be carefully chosen and the doses should be adjusted. Testing HLA-B~＊ 58： 01 for patients using allopurinol contributes to diagnosing and preventing allopurinol-induced SCAR. Clinical pharmacists,taking part in the clinical work and testing drug related genotypes,can help physicians diagnose accurately and make proper therapy decisions,thus reduce adverse drug reactions.