中文概要
题目
肾母细胞瘤更生霉素和长春新碱联合化疗并发中毒性表皮坏死松解症的报道
概要
中毒性表皮坏死松解症是一类临床罕见但严重威 胁患者生命的重症药疹,死亡率高达30%~50%。 儿童中最常见致敏药物为抗癫痫药、抗生素和解 热镇痛药。化疗药物引发中毒性表皮坏死松解症 报道少见。本文报道一例2 岁肾母细胞瘤患儿经 更生霉素联合长春新碱化疗1 周后并发严重皮肤 药物不良反应——中毒性表皮坏死松解症。本报 道旨在提醒肿瘤科医生警惕肿瘤患者治疗过程 中发生中毒性表皮坏死松解症这一高致死性重 症药疹的可能,需要在临床中密切观察患儿皮肤 表现,一旦出现相应症状须立即作为危重症处 理;同时提示皮肤科医生警惕化疗药更生霉素有 引发中毒性表皮坏死松解症的可能,发现此类病 人用药时出现皮疹应重视。早期识别并停用可疑 药物,联合积极支持治疗可显著改善患者预后, 降低死亡率。
References
Aznab, M., Khazaei, M., 2016. Stevens-Johnson syndrome patient received combination chemotherapy gemcitabine, cisplatin, and 5-FU for biliary tract cancer. Int. J. Cancer Manag., 9(3): e4211. http://dx.doi.org/10.17795/ijcp-4211
Chung, W.H., Wang, C.W., Dao, R.L., 2016. Severe cutaneous adverse drug reactions. J. Dermatol., 43(7): 758–766. http://dx.doi.org/10.1111/1346-8138.13430
Gravante, G., Delogu, D., Marianetti, M., et al., 2007. Toxic epidermal necrolysis and Steven-Johnson syndrome in oncologic patients. Eur. Rev. Med. Pharmacol. Sci., 11(4): 269–274.
Hockett, K.C., 2004. Stevens-Johnson syndrome and toxic epidermal necrolysis: oncologic considerations. Clin. J. Oncol. Nurs., 8(1): 27–55. http://dx.doi.org/10.1188/04.CJON.27-30
Jones, R., Kirkup, M., Guglani, S., et al., 2006. Toxic epidermal necrolysis after PCV combination chemotherapy for relapsed B-cell lymphoma. Clin. Oncol. (R. Coll. Radiol.), 18(1):90.
Schoeffler, A., Levy, E., Weinborn, M., et al., 2014. Stevens-Johnson syndrome and Hodgkin’s disease: a fortuitous association or paraneoplastic syndrome? Ann. Dermatol. Venereol., 141(2): 134–140 (in French). http://dx.doi.org/10.1016/j.annder.2013.10.051
Schwartz, R.A., McDonough, P.H., Lee, B.W., 2013. Toxic epidermal necrolysis: Part I. Introduction, history, classification, clinical features, systemic manifestations, etiology, and immunopathogenesis. J. Am. Acad. Dermatol., 69(2):173.e1-173.e13; quiz 185-186. http://dx.doi.org/10.1016/j.jaad.2013.05.003
Wu, J., Lee, Y.Y., Su, S.C., et al., 2015. Stevens-Johnson syndrome and toxic epidermal necrolysis in patients with malignancies. Br. J. Dermatol., 173(5): 1224–1231. http://dx.doi.org/10.1111/bjd.14052
Yang, C.H., Yang, L.J., Jaing, T.H., et al., 2000. Toxic epidermal necrolysis following combination of methotrexate and trimethoprim-sulfamethoxazole. Int. J. Dermatol., 39(8): 621–623. http://dx.doi.org/10.1046/j.1365-4362.2000.00022-3.x
Yoshifuku, K., Nishimoto, K., Matsuzaki, T., et al., 2015. A case of Stevens-Johnson syndrome developing during chemoradiotherapy for maxillary sinus cancer. Nihon Jibiinkoka Gakkai Kaiho, 118(12): 1436–1442 (in Japanese). http://dx.doi.org/10.3950/jibiinkoka.118.1436
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Project supported by the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding (No. ZYLX201601), the Project of Excellent Talents in Beijing City (No. 2013A003034000013), and the National Natural Science Foundation of China (No. 81602754)
ORCID: Yuan LIANG, http://orcid.org/0000-0002-0055-835X
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Liang, Y., Yang, Z., Xu, Zg. et al. Toxic epidermal necrolysis after dactinomycin and vincristine combination chemotherapy for nephroblastoma. J. Zhejiang Univ. Sci. B 18, 649–652 (2017). https://doi.org/10.1631/jzus.B1700065
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DOI: https://doi.org/10.1631/jzus.B1700065