血液透析聚砜膜引起的嗜酸性粒细胞增多症和全身症状(DRESS)药物反应综合征。

IF 1.4 4区 医学 Q3 UROLOGY & NEPHROLOGY Seminars in Dialysis Pub Date : 2024-09-01 Epub Date: 2024-05-21 DOI:10.1111/sdi.13207
Masatoshi Inoue, Momoko Sasamoto, Ryosuke Ichihara
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引用次数: 0

摘要

伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS)综合征是一种严重的、可能危及生命的超敏反应。尽管通常与特定药物有关,但尚未有医疗器械导致 DRESS 综合征的报道。我们报告了一例独特的 DRESS 综合征病例,该病例在治疗过程中与一种特殊的血液透析膜有关。一名 83 岁的男性患者在接受血液透析治疗期间出现发热、皮疹和嗜酸性粒细胞升高。尽管更换了药物并咨询了专家,但他的病情依然持续。药物诱导淋巴细胞刺激试验显示,他对透析膜的反应呈阳性。他的症状和实验室结果符合 DRESS 综合征的诊断标准。在更换透析膜和使用糖皮质激素后,患者的病情得到了早期改善。由于 DRESS 综合征的表现多种多样,且缺乏特定的基准,因此诊断 DRESS 综合征非常复杂。这一病例突出表明,有必要将医疗设备视为 DRESS 综合征的潜在诱因。提高医生的认识有助于及时发现和正确处理,最终改善患者的预后。
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Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome to Hemodialysis Polysulfone Membrane.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe and potentially life-threatening hypersensitivity reaction. Although commonly associated with specific drugs, there have been no reports of DRESS syndrome caused by medical devices. We report a unique case of DRESS syndrome linked to a particular hemodialysis membrane during treatment. An 83-year-old man on hemodialysis exhibited fever, rash, and elevated eosinophils. Despite medication changes and consultations with specialists, his condition persisted. A drug-induced lymphocyte stimulation test revealed a positive response to the dialysis membrane. His symptoms and lab results met DRESS syndrome diagnostic criteria. After substituting the membrane and administering glucocorticoids, the patient displayed early improvement. Diagnosing DRESS syndrome is complex due to its varied presentation and lack of specific benchmarks. This instance underscores the need to consider medical devices as potential DRESS syndrome triggers. Enhanced physician awareness can facilitate prompt detection and proper management, ultimately refining patient outcomes.

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来源期刊
Seminars in Dialysis
Seminars in Dialysis 医学-泌尿学与肾脏学
CiteScore
3.00
自引率
6.20%
发文量
91
审稿时长
4-8 weeks
期刊介绍: Seminars in Dialysis is a bimonthly publication focusing exclusively on cutting-edge clinical aspects of dialysis therapy. Besides publishing papers by the most respected names in the field of dialysis, the Journal has unique useful features, all designed to keep you current: -Fellows Forum -Dialysis rounds -Editorials -Opinions -Briefly noted -Summary and Comment -Guest Edited Issues -Special Articles Virtually everything you read in Seminars in Dialysis is written or solicited by the editors after choosing the most effective of nine different editorial styles and formats. They know that facts, speculations, ''how-to-do-it'' information, opinions, and news reports all play important roles in your education and the patient care you provide. Alternate issues of the journal are guest edited and focus on a single clinical topic in dialysis.
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