Recurrent Flexural Exanthema (SDRIFE or Baboon Syndrome) after Administration of Two Different Iodinated Radio Contrast Media
Recurrent Flexural Exanthema (SDRIFE or Baboon Syndrome) after Administration of Two Different Iodinated Radio Contrast Media
复制标题
使用两种不同的碘放射造影剂后复发性弯曲皮疹（SDRIFE 或狒狒综合症）
DOI：
10.1159/000096920
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发表时间：
2006
期刊：
影响因子：
3.4
通讯作者：
A. Bircher
中科院分区：
文献类型：
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作者：
A. Arnold;P. Häusermann;S. Bach;A. Bircher
1984年，狒狒综合征被描述为一种特殊形式的全身性接触性皮炎，发生在先前通过局部暴露于相同过敏原而致敏的个体中的接触性过敏原给药后。其临床表现为臀部和大腿内侧上部的红斑，类似狒狒的红屁股。这种特异性反应最初是用汞、镍和氨苄青霉素观察到的。自那时以来，已描述了100多起病例，其中大多数病例事先对病原体没有已知的过敏反应。在2004年，我们的小组提出了缩写SDRIFE专门用于与全身性药物相关的病例;它代表对称药物相关的摩擦和弯曲外展，作为与全身性药物相关的独特反应模式。在此，我们描述了一例使用碘化放射性造影剂（RCM）碘美普尔（Iomeron®）后发生SDRIFE的病例，该病例意外地被RCM碘普罗胺（Ultravist®）复制。观察到两种药物的阳性延迟皮肤试验，表明SDRIFE的病理机制可能是细胞介导的IV型过敏。口服碘化钾和皮肤试验阴性RCM的管理和耐受性，表明抗原是有关的分子，而不是碘本身。因此，在我们的病例中，皮肤试验具有良好的阳性和阴性预测值。
In 1984, the baboon syndrome was described as a particular form of systemic contact dermatitis that occurred after the administration of a contact allergen in individuals previously sensitized by topical exposure to the same allergen. Its clinical picture presents as an erythema of the buttocks and upper inner thighs resembling the red bottom of baboons. This specific reaction was originally observed with mercury, nickel and ampicillin. Since then over 100 cases have been described, most of them without known prior sensitization to the causative agent. In 2004, our group proposed the acronym SDRIFE specifically for cases associated with systemic drugs; it stands for symmetrical drug-related intertriginous and flexural exanthema, as a distinct reaction pattern related to systemic drugs. Here we describe a case of SDRIFE after administration of the iodinated radio contrast medium (RCM) iomeprol (Iomeron®), accidentally reproduced by the RCM iopromide (Ultravist®). Positive delayed skin tests with both drugs were observed indicating that the pathomechanism of SDRIFE is likely a cell-mediated type IV allergy. Oral potassium iodide and a skin-test-negative RCM were administered and both tolerated, indicating that the antigen is related to the molecules and not to iodine itself. Therefore, in our case skin tests had a good positive and negative predictive value.