儿童药物超敏反应综合征22例临床分析

发布时间：2018-06-30 18:01

本文选题：药物超敏反应综合征 + 发热　；参考：《临床儿科杂志》2017年07期

【摘要】：目的分析儿童药物超敏反应综合征(DIHS)临床诊断及治疗。方法回顾分析22例DIHS患儿的致敏药物、临床表现、实验室检查、治疗效果、并发症及预后。结果 22例患儿均有用药史并出现发热,90.9%患儿的皮疹表现为麻疹样红斑,肝脏受累占90.9%,肾损害占18.2%,浅表淋巴结肿大占54.5%,嗜酸粒细胞增多占36.4%。严重的合并症包括自身免疫性溶血性贫血1例,转氨酶升高10倍以上3例,合并肝衰竭、肝性脑病、多脏器衰竭死亡1例。治疗主要为系统使用糖皮质激素及丙种球蛋白,必要时可联合血浆置换。结论儿童DIHS潜伏期长,皮损形态以麻疹样皮疹为主,脏器受累多以肝脏为主,仅部分可合并嗜酸性粒细胞增多。糖皮质激素治疗有效。
[Abstract]:Objective to analyze the clinical diagnosis and treatment of drug hypersensitivity syndrome (DIHS) in children. Methods the sensitizers, clinical manifestations, laboratory findings, therapeutic effects, complications and prognosis of 22 patients with DIHS were retrospectively analyzed. Results all the 22 cases had a history of medication and 90.9% of the children had fever. The rash showed measles like erythema, liver involvement was 90.9%, renal damage was 18.2cm, superficial lymphadenopathy was 54.5%, and eosinophilic granulocyte was 36.4%. Severe complications included autoimmune hemolytic anemia in 1 case, transaminase elevation in 3 cases, liver failure, hepatic encephalopathy and multiple organ failure in 1 case. Treatment is mainly systematic use of glucocorticoids and gamma globulin, if necessary combined with plasma exchange. Conclusion the latent period of DIHS in children is long, the appearance of lesions is mainly measles like rash, the organ involvement is mainly liver, only some of them can be combined with eosinophil increase. Glucocorticoid therapy is effective.
【作者单位】：重庆医科大学附属儿童医院儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室重庆市儿童发育重大疾病国家国际科技合作基地;
【分类号】：R725.9

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