史蒂文斯·约翰逊综合征与Jarisch Herxheimer反应在HIV阳性的二期梅毒患者中。

IF 4.2 Q3 Pharmacology, Toxicology and Pharmaceutics
Sarah Micozzi, Patricia Rojas Perez-Ezquerra, Cristina Morales-Cabeza, Cristina Diez, Manuel De Barrio
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引用次数: 0

摘要

背景:HIV阳性患者可因感染性疾病引起许多并发症。对治疗中涉及的一些药物的严重药物反应可能与感染的症状重叠,使诊断非常困难。我们提出的情况下,一个28岁的男子,艾滋病毒阳性,与二期梅毒,谁开发了史蒂文斯约翰逊综合征(SJS)引起的许多药物之一,他收到。SJS与可能的Jarisch Herxheimer反应重叠,使皮肤反应的诊断复杂化。目的:在HIV+患者中,严重药物反应与传染性疾病的重叠可能是致命的,因此准确诊断是必须的。材料和方法:通过快速血浆反应素试验(RPR)、酶联免疫吸附试验(ELISA)、血液实验室检查、胸部x线摄影和皮肤活检来诊断感染性疾病和皮肤病变的原因。过敏试验采用皮内试验和双盲激发试验。结果:实验室检查证实梅毒诊断;皮肤活检证实病变原因,严重过敏反应为SJS。过敏症研究排除了所有涉及的药物,除了地吡酮,因为它的反应严重,成为致病药物的可能性很大,而且其他类似药物可以替代,所以在研究中没有得到证实。对于炎症反应,HIV+患者特别容易发生严重的反应,包括感染性和过敏性反应,就像本病例一样。因此,最近的专利强调了对引起炎症症状的炎症分子的兴趣。结论:虽然SJS的诊断有明确的标准,但可能与感染性疾病和/或与其治疗重叠,可能使诊断复杂化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Stevens Johnson Syndrome versus Jarisch Herxheimer Reaction in an HIV Positive Patient with Secondary Syphilis.

Background: HIV positive patients can suffer many complications due to infectious diseases. A sever drug reaction to some of the drugs involved in the treatment can overlap the symptoms of the infections, making the diagnosis very difficult. We present the case of a 28-year-old-man, HIV positive, with secondary syphilis, who developed a Stevens Johnson Syndrome (SJS) caused by one of the many drugs he received. The SJS was overlapped with a possible Jarisch Herxheimer Reaction, which complicated the diagnosis of the skin reaction.

Objective: In HIV+ patients, the overlapping of severe drug reactions and infectious diseases could be fatal, thus an accurate diagnosis is mandatory.

Material and methods: A Rapid Plasma Reagin Test (RPR), an ELISA test, a blood laboratory test, chest radiography and a skin biopsy were realized in order to diagnose the infectious disease and the cause of skin lesions. Intradermal tests and double blind challenge tests were realized in the allergy study.

Results: The laboratory tests confirmed the diagnosis of syphilis; the skin biopsy confirmed the cause of lesions, a severe allergic reaction as a SJS. The allergy study discharged all the drugs involved, except dypirone which wasn't proved in the study because of the severity of reaction, the high possibility to be the causative drug and the alternative of other similar drugs available. For the inflammatory response, HIV+ patients are especially susceptible to severe reaction, both infectious and allergic, as in this case. Thus, recent patents emphasize the interest in inflammatory molecules that cause inflammatory symptoms.

Conclusions: Although the diagnose of SJS has established criteria, the possibility of overlapping with infectious illness and/or with its treatment, may complicate the diagnosis.

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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
0
期刊介绍: Recent Patents on Inflammation & Allergy Drug Discovery publishes review articles by experts on recent patents in the field of inflammation and allergy drug discovery e.g. on novel bioactive compounds, analogs and targets. A selection of important and recent patents in the field is also included in the journal. The journal is essential reading for all researchers involved in inflammation and allergy drug design and discovery.
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