抗癫痫药高敏综合征临床分析及相关文献复习

Clinical Analysis of Antiepileptic Drug Hypersensitivity Syndrome and Related Literature Review

目的:分析抗癫痫药高敏综合征(AHS)的特点,提高医务人员对此病的认识。方法:回顾性分析1例经临床诊断的AHS患儿的临床资料。结果:患儿因免疫性脑炎、癫痫持续状态服用丙戊酸钠口服液每次6mL,每日2次,苯巴比妥片每次45mg,每日2次,托吡酯片每次31.25mg,每日2次。1个月后出现持续高热,周身严重斑丘疹、大疱疹,伴有瘙痒、皮肤剥脱,呼吸系统、肾脏、心肌损害,诊断为AHS,经相应治疗后病情逐渐好转。结论:AHS是一种特异质反应,其发病机制尚不清楚。用药史、临床表现、实验室检查是鉴别诊断此病的重要依据。早期识别、诊断,及时停用致敏药物并治疗是避免此病出现致命性损害的关键。

Objective : To analyze the characteristics of antiepileptic drug hypersensitivity syndrome (AHS) and enhance medical staff′s awareness of this disease. Methods : Retrospectively analysis the clinical data of a clinically diagnosed AHS child. Results : The child was given sodium valproate oral solution 6 mL/time, 2 times/day. Phenobarbital tablets 45 mg/time, 2 times/day. Topiramate tablets 31.25 mg/time, 2 times/day. Due to autoimmune encephalitis and status epilepticus. One month later, the patient occurred persistent high fever, severe maculopapular rash, herpes, accompanied by itching, skin exfoliation, and respiratory system, kidney, myocardial damage, and diagnosed as AHS. After corresponding treatment, the patient′s condition improved. Conclusion : AHS is an idiosyncratic reaction,the pathogenesis is still unclear.Medication history, clinical manifestations, laboratory examinations are important basis for the differential diagnosis.Early identification, diagnosis,timely discontinuing of the suspected drugs and treatment are the keys to avoid fatal damage.