奥氮平致DRESS综合征1例

Prosenjit Ghosh, Ankur Bhattacharya
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摘要

DRESS综合征(伴有嗜酸性粒细胞增多和全身症状的药物反应)被定义为一种药物引起的复杂症状,包括发烧、皮疹、淋巴结病、嗜酸性粒细胞增多和各种轻度至重度全身表现。我们在此报告一例24岁的女性,在服用奥氮平30天后出现严重的全身红斑、皮肤红斑、面部浮肿、全身发红、发烧、嗜酸性粒细胞增多、白细胞增多和肝炎。考虑到发热、嗜酸性粒细胞增多、淋巴结肿大、典型皮疹和脏器受累的发生,使用RegiSCAR标准做出DRESS综合征的“可能诊断”。精神药物引起的DRESS几乎没有报道。广泛报告和教育临床医生和患者关于DRESS将导致降低发病率和死亡率。在阐明其发病机制和设计个性化治疗方案方面需要进一步的研究。
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A case report of Olanzapine induced DRESS Syndrome
DRESS syndrome (Drug reaction with eosinophilia and systemic symptoms) is defined as a drug-induced complex of symptoms consisting of fever, rash, lymphadenopathy, eosinophilia and a wide range of mild to severe systemic presentations. Here we report a case of a 24-year-old female who developed a severe generalized Anasarca, skin erythema, facial puffiness, reddish discoloration over the body, fever, eosinophilia, leukocytosis and hepatitis 30 days after ingestion of olanzapine. Considering the occurrence of fever, eosinophilia, enlarged lymph nodes, typical skin rash and internal organ involvement, a ‘’ Probable diagnosis “of DRESS syndrome was made using the RegiSCAR Criteria. DRESS induced by psychotropic medications have been scarcely reported. Extensive reporting and educating clinicians as well as patients regarding DRESS will lead to decreased morbidity as well as mortality. Further research is warranted in elucidating its pathogenesis with the aim of designing personalized treatment plans.
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