Association between HLA-B*1502 allele and antiepileptic drug-induced cutaneous reactions in Han Chinese

A previous study conducted in Taiwan found a 100% association between HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome (SJS) in Han Chinese subjects, with an extremely high odds ratio compared with carbamazepine-tolerant subjects (odds ratio = 2,504). We examined this association in 24 Hong Kong Han Chinese subjects who had cutaneous adverse reactions induced by different antiepileptic drugs (AEDs). They were matched with 48 AED-tolerant controls. HLA-B*1502 was associated with severe cutaneous reactions (SCR) induced by AEDs, which included carbamazepine, phenytoin, and lamotrigine (p = 0.001, odds ratio = 17.6), but was not associated with maculopapular exanthema (MPE) (p = 0.32). Further studies in larger samples of ethnically matched subjects should be conducted to confirm the findings. Identification of genetic polymorphisms predisposing to development of AED-induced SCR offers the possibility of avoiding these high-risk drugs in genetically susceptible individuals.     

Reintroduction of treatment with lamotrigine in combination with valproate after an initial allergic skin reaction

INTRODUCTION: Lamotrigine (LTG) is effective for a variety of seizure types especially against absence seizures in cotherapy with valproate (VPA). Skin rash is the most frequent side effect leading to LTG discontinuation. OBSERVATIONS: We report two patients with refractory absence epilepsy and a previous history of allergic reaction to LTG in which LTG was rechallenged. LTG was effective in both cases without incident. DISCUSSION: High initial dose and rapid dose escalation is associated with increased rash rate. LTG is contraindicated in patients who have demonstrated hypersensitivity to the drug. However, because the initial dose and the dose titration play a crucial role, LTG was reintroduced with a very low initial dose and very slow titration schedule without recurrence of skin rash. CONCLUSION: Patients who have experienced a previous mild skin allergy may be reconsidered for a rechallenge with LTG if the expected therapeutic response to the drug is high. Patients must be warned about the risks.     

维生素A-D滴剂联合珍珠粉治疗新生儿红臀的效果观察

目的观察维生素A-D滴剂联合珍珠粉治疗新生儿红臀的效果。方法对100例红臀患儿进行随机分组,分为观察组和对照组各50例。观察组每次治疗前常规先用温水擦拭患处,再涂上维生素A-D滴剂和珍珠粉的混合药物,对照组患儿每次治疗前也用温水擦拭干净患处,给予涂上维生素A-D滴剂,观察两组患儿红臀治疗的效果。结果经过1个疗程的治疗后发现观察组的总有效率明显大于对照组(p<0.05)。结论维生素A-D滴剂联合珍珠粉治疗新生儿红臀的效果明显优于单纯用维生素A-D滴剂,能较好的治疗新生儿轻度、重I度及重II度红臀,从而预防了重症红臀的发生。     

非典型麻疹36例

自20世纪60年代中期我国普遍推广麻疹活疫苗后,麻疹的发病率和死亡率明显下降,但非典型麻疹发病率逐渐增高,我院2000年至2004年收治的麻疹病人中有36例非典型麻疹,现分析如下。1临床资料36例中男性24例,女性12例,年龄1岁~5岁,均接种过麻疹疫苗1次,未复种。发病季节以冬末早春较多。城镇儿童10例,农村26例。发热病人,体温37.5℃~38.5℃20例,39℃8例,39.5℃6例,39.5℃以上2例。眼结膜充血流泪畏光20例,流涕打喷嚏16例。出现麻疹黏膜斑25例,皮疹:发热2d、3 d、4 d、5 d后出疹分别为15例、10例、6例、5例。皮疹稀疏淡红24例,典型皮疹12例,皮疹由…     

烂喉痧(猩红热)病史考略

烂喉痧病曾是我国近代猖獗一时的流行性传染病,夺走无数人的宝贵生命。医界人士对此病予以高度重视,从临床医家到理论研究人员从各个角度进行了深入研究,并得出一个公正的结论：即在西医有效疗法未问世之前,祖国医药曾对此病的防治做出重大的贡献。     

379例发热出疹性疾病血清流行病学分析

为了解四川省发热出疹性疾病（RFIs）的血清流行病学特征,以便更好地开展麻疹监测,1997～2000年5月,在该省20个县采集了暴发和散发病例的急性期血清标本,用酶联免疫吸附试验(ELISA)捕捉法检测麻疹和风疹IgM抗体。结果379例中确诊为麻疹的192例（50.66％）,风疹80例（21.11％）,其它RFIs107例（28.23％）。379份血清标本中,麻疹IgM抗体阳性144份,阳性率37.99％;风疹IgM抗体阳性40例（10.55％）。RFIs发病高峰季节为春季,发病以＜15岁儿童为主,暴发病例以麻疹为主。血清学诊断是科学鉴别RFIs的重要手段。加强麻疹疫苗的有效接种和强化免疫,是加速控制麻疹的主要策略。     

胰岛素过敏一例及文献回顾

目的 加强对糖尿病患者胰岛素过敏的认识.方法 报道一例具有完整临床和辅助检查资料的胰岛素过敏的患者,并结合文献复习进行分析.结果 患者胰岛素过敏诊断明确,给予停用诺和灵胰岛素,改用优泌林胰岛素后血糖控制良好,无胰岛素过敏情况再次发生.结论 胰岛素过敏少见,可根据其病史及临床表现做出正确诊断,停用或改用其他种类胰岛素后可在血糖控制良好的情况下避免胰岛素过敏再次发生.     

10例接种麻风疫苗后发热出疹性疾病的病例分析

[目的]调查接种麻风疫苗后发生发热出疹性疾病(RFIs)的情况。[方法]对昌平区2009年10例RFIs进行流行病学调查。[结果]接种麻风疫苗后RFIs的发生呈散发状态,且相互之间无流行病学联系;以麻风疫苗接种人次数进行估算,报告发生率为5.32/万;20.00%的病例发热﹥38.5℃,出疹时间在麻风疫苗接种后5～10d(平均为7d),出疹顺序基本同麻疹病例,皮疹较为典型;全部病例均为8～15月龄首次接种麻风疫苗者。[结论]接种麻风疫苗可引起发热出疹性疾病,其发生与疫苗首次接种有关。病例是否与接种有因果关系,有待进一步从病毒基因型别上加以确认。