柳氮磺吡啶致超敏反应综合征

Hypersensitivity syndrome caused by sulfasalazine

1例40岁女性患者因脊柱关节炎服用柳氮磺吡啶0.75 g、3次/d。服药第20天,患者全身出现皮疹,逐渐加重,伴发热、淋巴结肿大和脾大,实验室检查发现白细胞计数14.4×10^9/L,嗜酸粒细胞计数0.82×10^9/L,尿潜血(+++)、丙氨酸转氨酶84 U/L,天冬氨酸转氨酶96 U/L,诊断为药物超敏反应综合征,考虑与柳氮磺吡啶有关。停用柳氮磺吡啶,给予甲泼尼龙联合人免疫球蛋白静脉滴注,同时辅以抗感染、抗过敏、保肝等治疗。8 d后皮疹开始消退,瘙痒好转;18 d后皮疹基本消退,实验室检查结果恢复正常。

A 40-year-old female patient was treated with sulfasalazine 0.75 g thrice daily for spondyloarthritis.On the 20th day of medication,the patient developed skin rash all over the body,which was gradually aggravated and accompanied by fever,lymphadenectasis,and splenomegaly.Laboratory tests revealed the white blood cell count 14.4×10^9/L,the eosinophil count 0.82×10^9/L,the urinary occult blood(+++),alanine aminotransferase 84 U/L,and aspartate aminotransferase 96 U/L.Drug-induced hypersensitivity syndrome was diagnosed and considered to be related to sulfasalazine.Sulfasalazine was discontinued and intravenous infusions of methylprednisolone combined with human immunoglobulin were given.At the same time,anti-infection,anti-allergy,and liver-protective treatments were given additionally.After 8 days of treatments,the rash began to subside and itching was improved;after 18 days,the rash basically subsided and laboratory tests showed the results returned to normal.