Treatment of severe drug reactions by hemodialysis.
Treatment of severe drug reactions by hemodialysis.
复制标题
通过血液透析治疗严重药物反应。
DOI：
10.1111/ijd.13837
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发表时间：
2018
影响因子：
3.6
通讯作者：
Hickson,LaTonyaJ
中科院分区：
文献类型：
--
作者：
El-Azhary,RokeaA;Wang,MichaelZ;Wentworth,AshleyB;Hickson,LaTonyaJ
背景：血液透析、血浆置换等体外治疗是治疗药物中毒的救命手段。这种治疗方法一般不用于严重的皮肤和全身药物反应。方法在此，我们描述了三个病例，其中血液透析治疗是扭转药物不良反应的工具。结果在所回顾的严重皮肤药物反应病例中，患者表现为线状免疫球蛋白A大疱性皮肤病、急性全身性脓疱病和中毒性表皮坏死松解。补救性治疗与血液透析疗法显著影响病程，导致缓解。结论这种新颖高效的治疗方案在目前的药物不良反应算法中未被考虑。因此，除了这些反应罕见之外，该研究的主要限制是患者数量少。血液透析可以大大改变预后，在某些情况下，对于伴有全身毒性的严重皮肤药物不良反应的患者，血液透析是一种挽救生命的治疗方法。
BackgroundExtracorporeal treatments such as hemodialysis and plasma exchange are lifesaving measures in the treatment of drug poisoning. This treatment method generally is not used for severe cutaneous and systemic drug reactions.MethodsHere, we describe three cases wherein hemodialysis therapy was instrumental in reversing the adverse drug reaction.ResultsIn the cases of severe cutaneous drug reactions reviewed, patients presented with linear immunoglobulin A bullous dermatosis, acute generalized exanthematous pustulosis, and toxic epidermal necrolysis. Salvage treatment with hemodialysis therapy drastically influenced the course of disease, resulting in remission.ConclusionsThis novel and highly effective treatment option is not considered in current algorithms for adverse drug reactions. Hence, in addition to the rarity of these reactions, the main limitation of the study is the small number of patients. Hemodialysis can substantially alter the prognosis and, in some cases, be a lifesaving treatment for patients with severe adverse cutaneous drug reaction associated with systemic toxicity.