药物超敏综合征并横纹肌溶解综合征一例

患者女,20岁,因全身皮疹、发热伴肝功能损害20余天就诊.皮肤科检查:面部、四肢非凹陷性水肿、潮红,全身大量糠状细小脱屑,双下眼睑可见轻微红斑,上覆细小鳞屑.实验室检查:嗜酸粒细胞1.67×109/L,丙氨酸转氨酶214 U/L,天冬氨酸转氨酶105 U/L,肌酸激酶962 U/L,乳酸脱氢酶519 U/L,肌红蛋白608 ng/ml,肌电图检查:肌源性受损.诊断为药物超敏综合征并横纹肌溶解综合征.入院后给予甲泼尼龙40 mg静脉滴注,每天1次,治疗1周后患者临床症状及肝肾功能等血生化指标恢复正常,好转出院,门诊随访,至今病情无反复.

A case of drug hypersensitivity syndrome accompanied by rhabdomyolysis

A 20-year-old female presented with generalized skin eruptions,fever and hepatic damage for more than 20 days.Skin examination demonstrated nonpitting edema and flushing of the face and extremities as well as mild erythema of both lower eyelids with furfur-like fine scales all over the body surface.Laboratory examination showed that eosinophil count was 1.67 × 109/L,serum alanine transarninase (ALT) level 214 U/L,serum aspartate aminotransferase (AST) level 105 U/L,serum creatine kinase (CK) level 962 U/L,serum lactate dehydrogenase (LD) level 519 U/L,serum myoglobin level 608 ng/ml.Electromyogram (EMG) revealed myogenic lesions.The diagnosis of drug hypersensitivity syndrome accompanied by rhabdomyolysis was made.The patient was treated with intravenous methylprednisolone 40 mg once daily after hospitalization.One week after the initiation of treatment,clinical symptom improved with the normalization of liver and renal function and she was discharged from the hospital.Up to the time of this writing,no recurrence had been noted.