药源性重症多形红斑18例临床分析

目的:总结分析药源性重症多形红斑的临床资料、治疗及转归。方法:回顾性分析18例药物所致的重症多形红斑患者的一般资料、临床表现、实验室及辅助检查、治疗及转归。结果:致病药物以别嘌醇和卡马西平多见。患者除有皮肤损害外,还伴有黏膜损害,50%的患者有肝、肾受累。18例患者均采用足量糖皮质激素治疗,4例患者给予大剂量静脉注射用人免疫球蛋白治疗。除2例患者因肾衰及消化道出血致死外,其余患者均治愈。结论:及早采用中至大剂量糖皮质激素对促进皮损愈合、缩短病程有帮助,对病情难以控制的患者可早期应用大剂量静脉注射用人免疫球蛋白治疗。

Analysis of 18 cases of drug-induced major erythema multiforme

Eighteen cases of drug-induced major erythema multiforme from 2000 to 2004 were studied retrospectively. Allopurinol and carbamazepine were the most common offending agents in these patients (11/18). Aside from skin lesions, mucous membrane was involved in all cases, and dysfunctions of liver or kidney were observed in 50% cases. Adequate amounts of corticosteroids were used in all cases and aggressive dosage of immunoglobulins were given intravenously to four patients. Sixteen cases were cured and two died from renal failure and hemorrhage of digestive tract respectively.