火灾(发热感染伴难治性癫痫综合征)患儿服用氯巴扎明引起皮疹的罕见不良反应

Saheli Das, Afshan Jabeen
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摘要

氯巴扎姆是一种芳香族抗癫痫药物,其活性代谢产物去甲基氯巴扎姆对γ-氨基丁酸受体具有高亲和力和激动活性,可抑制神经元的异常和过度活动。据报道,氯巴扎姆引起斑丘疹的发生率小于 1%。一名被诊断为发热性感染相关癫痫综合征的 13 岁男性在服用氯巴扎姆后第二天出现全身红斑皮疹。随后停用了氯巴扎姆,17 天后再次用药。然而,在重新使用氯巴扎姆后,皮疹没有再出现。据观察,皮疹出现时患者正在服用氟康唑。氟康唑是一种强效的 CYP2C19 抑制剂,会导致活性代谢物去甲氯苄肼的水平升高,这可能是导致皮疹的原因。根据世界卫生组织乌普萨拉监测中心的标准,因果关系评估被认为是可能的。对药物不良反应进行了记录和报告。
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A RARE ADVERSE EFFECT OF CLOBAZAM INDUCED RASH IN A CHILD WITH FIRES (FEBRILE INFECTION WITH REFRACTORY EPILEPSY SYNDROME)
Clobazam, an aromatic antiepileptic drugs and its active metabolite desmethylclobazam, has high affinity and agonistic activity on gamma-aminobutyric acid receptors resulting in suppression of abnormal and excessive activity of neurons. The reported incidence of maculopapular rash with Clobazam is <1%. A 13-year-old male with a diagnosis of febrile infection-related epilepsy syndrome developed a generalized erythematous maculopapular rash the next day following the introduction of Clobazam. Following this event, Clobazam was stopped and reintroduced after 17 days. However, the rash did not appear after its reintroduction. It was observed that the patient was on Fluconazole when the rash appeared. Fluconazole being a strong CYP2C19 inhibitor, results in an increased level of active metabolite, desmethylclobazam, which probably could have caused the rash. According to the World Health Organization, Uppsala Monitoring Centre Criteria, causality assessment was found to be probable. Adverse drug reaction was recorded and reported.
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