羟苯磺酸钙胶囊致中毒性表皮坏死松解症2例

Toxic epidermal necrolysis caused by calcium dobesilate capsules： report of 2 cases

2例女性患者（例1，63岁；例2，51岁）因高血压病和慢性肾功能不全服用羟苯磺酸钙胶囊0.5 g，3次/d。例1于服药第15天左上肢出现红色皮疹伴高热，例2于服药第20天躯干和双大腿部出现红色皮疹，伴咳嗽和高热；分别于出疹后1 d（例1）和3 d（例2）发展至全身皮疹；分别于出疹后3 d（例1）和9 d（例2）出现口腔、双眼、外阴黏膜处破溃。诊断：羟苯磺酸钙胶囊致中毒性表皮坏死松解症。停用羟苯磺酸钙胶囊，给予糖皮质激素、人免疫球蛋白、补钾、补钙等治疗。分别在治疗13 d（例1）和18 d（例2）黏膜糜烂处愈合或好转，16 d（例1）和25 d（例2）后皮疹消退。

Two female patients （patient 1, 63 years old; patient 2, 51 years old） with hypertension and chronic renal insufficiency received calcium dobesilate capsules 0.5 g thrice daily. Patient 1 developed red rash on her left upper limb, accompanied by high fever 15 days after medication. Patient 2 developed red rash on her trunk and both thighs, accompanied by cough and high fever 20 days after medication. They developed rash all over the body 1 day （patient 1） and 3 days （patient 2）, respectively after the rash occurrence, ulceration on oral mucosa, binoculus, and pudendum 3 days （patient 1） and 9 days （patient 2）, respectively after the rash occurrence. They were diagnosed as toxic epidermal necrolysis due to calcium dobesilate capsules. Calcium dobesilate capsules were stopped, and glucocorticoid, human immune globulin, supplement of potassium and calcium, etc. were given. The mucosal erosions were healed or improved on day 13 （patient 1） and 18 （patient 2） of treatments, respectively. The rash faded after 16 days （patient 1） and 25 days （patient 2） of treatments, respectively.