拉莫三嗪致肝硬化癫痫患者药物超敏反应综合征1例
Drug Hypersensitivity Syndrome in Cirrhotic Epilepsy Induced by Lamotrigine: A Case Report
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1.青岛市中医医医院消化中心,青岛 266000
2.青岛市中医医医院消化中心,青岛 266000
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徐佳,张向磊,吴国志.拉莫三嗪致肝硬化癫痫患者药物超敏反应综合征1例[DB/OL].(2023-11-13)[2023-11-13].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43867707&Fpath=home&index=0&lang=zh
XU Jia,ZHANG Xianglei,WU Guozhi.Drug Hypersensitivity Syndrome in Cirrhotic Epilepsy Induced by Lamotrigine: A Case Report[J].,
徐佳,张向磊,吴国志.拉莫三嗪致肝硬化癫痫患者药物超敏反应综合征1例[DB/OL].(2023-11-13)[2023-11-13].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43867707&Fpath=home&index=0&lang=zh DOI:
XU Jia,ZHANG Xianglei,WU Guozhi.Drug Hypersensitivity Syndrome in Cirrhotic Epilepsy Induced by Lamotrigine: A Case Report[J]., DOI:.
病史摘要,2,患者王某,男,因“高热伴皮肤红斑疹半个月,溃脓6天”于2019年9月8日入院。既往乙肝、肝硬化病史,2个月前因癫痫一直口服拉莫三嗪,半个月前肢瘙痒,手心少许红疹,逐渐出现颜面部、手脚等部位广泛皮疹、肿胀,并迅速累及全身。中医诊断 药毒/肝着(热毒湿阻,热毒入营)。西医诊断 1.药物超敏反应综合征2.癫痫3.肝硬化(乙肝性,代偿期)4.皮肤感染 5.低蛋白血症。干预措施 中草药前期清热凉血燥湿,解毒护阴为法,后期清热扶正养阴为法。西医以抗感染、保肝、营养支持、糖皮质激素、抗病毒等治疗,配合中西医结合清创换药。疗效转归 病情逐渐好转出院,随诊无反复。
Summary of case history, The patient surnamed Wang, male, was admitted to hospital on September 8, 2019 due to "high fever accompanied by skin erythematous rash for half a month and festering for 6 days". With a history of hepatitis B and cirrhosis, she had been taking lamotrigine orally for epilepsy 2 months ago, and had pruritus on the front limbs for half a month and a little red rash on the palms. Extensive rash and swelling gradually appeared on the face, hands and feet, and quickly involved the whole body.,TCM diagnosis, Drug toxicity/liver heat toxicity dampness/heat toxicity into the campWestern medicine diagnosis 1. Drug hypersensitivity syndrome 2. Epilepsy 3. Liver cirrhosis (hepatitis B compensatory stage) 4. Skin infection 5. Hypoproteinemia Therapeutic methods,Clinical outcomes, Herbs in the early stage of clearing heat, cooling blood and drying dampness, detoxification and protecting Yin is the method, and in the late stage of clearing heat and fuzheng and nourishing Yin is the method. Western medicine uses anti-infection, liver protection, nutritional support, glucocorticoid, antiviral treatment, combined with traditional Chinese and Western medicine debridement and dressing change.
药物超敏反应综合征拉莫三嗪药疹
中国医师协会皮肤科医师分会.药物超敏反应综合征诊治专家共识.中华皮肤科杂志,2018,51(11):787-790。
中国医师协会皮肤科医师分会自身免疫性疾病亚专业委员会.糖皮质激素治疗免疫相关性皮肤病专家共识(2018). 中华临床免疫和变态反应杂志, 2018,12(1):1-7。
潘锋.药物性肝损伤是最常见的不良反应——访首都医科大学附属北京地坛医院谢雯教授[J]. 中国医药导报,2020,32:1-3。
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