Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms due to lamotrigine differs from that due to other drugs
Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms due to lamotrigine differs from that due to other drugs
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拉莫三嗪引起的药物过敏综合征/药物反应（伴有嗜酸性粒细胞增多和全身症状）与其他药物引起的药物反应不同
DOI：
10.1111/1346-8138.14776
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Watanabe Hideaki
中科院分区：
文献类型：
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作者：
Tashiro Yasuya;Azukizawa Hiroaki;Asada Hideo;Niihara Hiroyuki;Morita Eishin;Yamauchi Teruo;Mizukawa Yoshiko;Kusakabe Yoshio;Numazawa Satoshi;Izumi Miki;Sueki Hirohiko;Watanabe Hideaki
药物诱发的超敏反应综合征（DIHS），也称为嗜酸性粒细胞增多和全身症状的药物反应（DRESS），是一种以血液学异常和人疱疹病毒-6（HHV-6）重新激活为特征的多器官全身药物反应。 DIHS/DRESS 通常与有限数量的药物相关，例如抗惊厥药。我们组已治疗了 12 例因拉莫三嗪 (LTG) 引起的 DIHS/DRESS 患者，但他们的表现与其他药物引起的 DIHS/DRESS 患者不同。本研究的目的是确定 LTG 与其他药物引起的 DIHS/DRESS 之间的显着差异。我们回顾性分析了 12 例由 LTG 引起的 DIHS/DRESS 患者和 32 例由其他药物引起的 DIHS/DRESS 患者的数据。由于其他药物的影响，LTG 组丙氨酸转氨酶水平的升高明显较 DIHS/DRESS 组温和。 DIHS/DRESS 期间，LTG 组血液中非典型淋巴细胞的百分比较低。 LTG 组的乳酸脱氢酶和胸腺以及活化调节趋化因子的血清水平也较低。 LTG 组中 HHV-6 再激活的 DIHS/DRESS 患者少于其他药物治疗组。 LTG 组在 DIHS/DRESS 发作后淋巴细胞转化更快。两组在从首次服用药物到出现皮疹的时间间隔、白细胞计数、血嗜酸性粒细胞增多或 DRESS 评分方面没有差异。两组之间没有显着的组织病理学差异。 LTG 相关 DIHS/DRESS 和其他药物引起的 DIHS/DRESS 的特征有所不同。
Drug‐induced hypersensitivity syndrome (DIHS), also referred to as drug reaction with eosinophilia and systemic symptoms (DRESS), is a multi‐organ systemic drug reaction characterized by hematological abnormalities and reactivation of human herpesvirus‐6 (HHV‐6). DIHS/DRESS is typically associated with a limited number of drugs, such as the anticonvulsants. Our group has treated 12 patients for DIHS/DRESS due to lamotrigine (LTG), but their presentation differed from that of patients with DIHS/DRESS caused by other drugs. The aim of the present study was to identify significant differences between DIHS/DRESS caused by LTG versus other drugs. We retrospectively reviewed data of 12 patients with DIHS/DRESS caused by LTG and 32 patients with DIHS/DRESS due to other drugs. The increase in alanine aminotransferase level was significantly milder in the LTG group than the DIHS/DRESS group due to other drugs. The percentage of atypical lymphocytes in the blood during DIHS/DRESS was lower in the LTG group. Serum levels of lactate dehydrogenase and thymus and activation‐regulated chemokine were also lower in the LTG group. There were fewer DIHS/DRESS patients with HHV‐6 reactivation in the LTG group than in the group treated with other drugs. Lymphocyte transformation after DIHS/DRESS onset was faster in the LTG group. The two groups did not differ with respect to the interval from first drug intake to rash, white blood cell count, blood eosinophilia or DRESS score. There were no significant histopathological differences between the two groups. The features of LTG‐associated DIHS/DRESS and DIHS/DRESS due to other drugs differ.