拉莫三嗪可能诱发噬血细胞综合征1例

Lamotrigine may induce hemophagocytic syndrome:A case report

噬血细胞综合征是一类由原发性或继发性免疫异常导致过度炎症反应的急危重症疾病,儿童较成人常见。本文报告1例癫痫性精神病患者在使用拉莫三嗪等抗癫痫药物治疗过程中出现反复发热、皮疹,外周血两系减少(白细胞、血小板),肝功能受损,脾大,铁蛋白增加,骨髓穿刺发现嗜血细胞,明确诊断为噬血细胞综合征,使用糖皮质激素治疗效果显著。本病例提出了拉莫三嗪可能导致严重免疫系统反应-嗜血细胞性淋巴组织增多症,早期快速鉴别、诊断、治疗,可显著改善患者结局。

Hemophagocytic syndrome is a kind of acute and critical disease with excessive inflammatory reaction caused by primary or secondary immune abnormalities.It is more common in children than in adults.This paper reports a case of epileptic psychosis who suffered from repeated fever and rash,decreased peripheral blood lineages(leukocytes and platelets),impaired liver function,splenomegaly,increased ferritin,hemophilia found by bone marrow puncture during the treatment with lamotrigine and other antiepileptic drugs.The diagnosis was hemophagocytic syndrome,and the treatment effect was satisfactory with glucocorticoids.This case suggests that lamotrigine may cause severe immune system reaction-hemophagocytic lymphohistiocytosis.Early and rapid identification,diagnosis and treatment can significantly improve the patient's prognosis.