CAJ | 학술논문

目的：探讨别嘌呤醇致药物超敏综合征( drug rash with eosinophilia and systemic symptoms, DRESS)的临床特点及治疗方法。方法回顾分析我院近年收治3例别嘌呤醇致DRESS的临床资料。结果本文3例因痛风或高尿酸血症服用别嘌呤醇后1~2周左右出现全身弥漫性皮疹伴发热、肝肾功能损伤、血液学改变,2例出现少尿,1例出现胆汁淤积性黄疸。经相关医技检查及病因排查均诊断为别嘌呤醇过敏,DRESS。3例均予糖皮质激素和(或)联合丙种球蛋白治疗,2例病情缓解,但糖皮质激素减量过程中出现病情反复,1例死亡；另1例病情恶化放弃治疗。结论别嘌呤醇致DRESS临床表现多样,早期大剂量糖皮质激素治疗可有效控制症状,病情缓解后糖皮质激素减量应缓慢,并警惕复发。
목적：탐토별표령순치약물초민종합정( drug rash with eosinophilia and systemic symptoms, DRESS)적림상특점급치료방법。방법회고분석아원근년수치3례별표령순치DRESS적림상자료。결과본문3례인통풍혹고뇨산혈증복용별표령순후1~2주좌우출현전신미만성피진반발열、간신공능손상、혈액학개변,2례출현소뇨,1례출현담즙어적성황달。경상관의기검사급병인배사균진단위별표령순과민,DRESS。3례균여당피질격소화(혹)연합병충구단백치료,2례병정완해,단당피질격소감량과정중출현병정반복,1례사망；령1례병정악화방기치료。결론별표령순치DRESS림상표현다양,조기대제량당피질격소치료가유효공제증상,병정완해후당피질격소감량응완만,병경척복발。
Objective To explore the clinical features and treatment of drug hypersensitivity syndrome ( drug rash with eosinophilia and systemic symptoms, DRESS) caused by allopurinol. Methods Clinical data of 3 patients with DRESS caused by allopurinol admitted to our hospital in recent years were retrospectively analyzed. Results Three patients com-plained of fever, generalized rash, impaired renal and hepatic function and hematologic abnormalities after 1-2 weeks of allo-purinol treatment for gout or hyperuricemia. Two patients developed oliguria, and the other one developed cholestasis icterus. Three patients were all diagnosed as having allopurinol allergy, DRESS, and were all treated with glucocorticosteroid or com-bined with intravenous immunoglobulin. Two patients had dramatic improvement in clinical condition, but relapsed as glu-cocorticosteroid tapered off. One of the patients died and one gave up further therapy after his condition deteriorated. Conclu-sion The clinical presentation of drug hypersensitivity syndrome caused by allopurinol is diverse. High-dose glucocorticoste-roid administered early can provide dramatic improvement in clinical condition, but relapse occurs when prednisone is tapered. So a slow taper off of glucocorticosteroid is required upon remission.