药物超敏反应综合征并人类免疫缺陷病毒感染 1例及文献复习

目的 提高临床医师对药物超敏反应综合征和人类免疫缺陷病毒（HIV）感染者/艾滋病病人药疹的认识，减少误诊。方法回顾性分析2021年11月于兰州大学第二医院住院的1例药物超敏反应综合征伴HIV感染者的临床资料，并行文献复习。结果 病人因“全身出红斑伴痒20 d”入院，入院前有复杂的用药史，入院后反复发热，查体面部水肿、淋巴结肿大、脾大，辅助检查提示嗜酸性粒细胞明显升高、HIV抗体筛查阳性，明确诊断为药物超敏反应综合征，予以糖皮质激素联合人免疫球蛋白为主的治疗，病情缓解。结论 药物超敏反应综合征是一种病毒激活相关的重症药疹，典型特征为发热、皮疹、面部水肿、嗜酸性粒细胞升高、淋巴结肿大、肝酶异常和病情反复，系统使用糖皮质激素联合人免疫球蛋白治疗有效。HIV感染可参与该病的发生发展。

A case of drug induced hypersensitivity syndrome combined with HIV infection and literature review

Objective To improve the understanding and reduce misdiagnosis of drug induced hypersensitivity syndrome and drugeruption in human immune deficiency virus/Acquired Immune Deficiency Syndrome patients.Methods The clinical data of a patientwith drug induced hypersensitivity syndrome combined with HIV infection who was admitted to Lanzhou University Second Hospital inNovember 2021 were selected, and the literature was reviewed in parallel.Results The patient was admitted to the hospital for erythe.ma all over the body with itching for 20 days. He had a complicated drug history before admission. After admission, he had repeated fe.ver, facial swelling, splenomegaly, lymphadenectasis and the auxiliary examination showing that eosinophils were significantly elevat.ed, anti-HIV positive. He was clearly diagnosed as drug induced hypersensitivity syndrome and treated by glucocorticoids combinedwith human immunoglobulin. The condition was relieved.Conclusions Drug-induced hypersensitivity syndrome is a severe drug erup.tion related to the viruses activation. The typical symptoms are fever, rash, facial swelling, elevated eosinophils, lymphadenectasis, liverabnormalities and recurrence. Systematic treatment with glucocorticoids combined with human immunoglobulin is effective. HIV infec.tion can involve in the development of the disease.