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首页> 外文期刊>Ibnosina Journal of Medicine and Biomedical Sciences >Sudden worsening of DRESS syndrome on tapering steroid dose with dramatic improvement on N-acetylcysteine and steroid dose escalation
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Sudden worsening of DRESS syndrome on tapering steroid dose with dramatic improvement on N-acetylcysteine and steroid dose escalation

机译：逐渐减少类固醇剂量使DRESS综合征突然恶化，N-乙酰半胱氨酸和类固醇剂量增加明显改善

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摘要

DRESS syndrome (Drug Reaction with Eosiophilia and Systemic Symptoms) is a serious and life-threatening drug reaction characterized by fever, skin rash, peripheral eosinophilia, presence of atypical lymphocytes in peripheral blood smear, generalized lymphadenopathy and involvement of other body organs. The only agreed upon therapy for DRESS syndrome in literature is withholding the culprit drug. There are no controlled trials on the use of steroids in this condition. The optimal dose of corticosteroids, the duration of therapy and their effect on mortality is unknown. Reports on the use of N-acetylcysteine in DRESS syndrome can be counted on the fingers of one hand. In this paper we report a case of severe DRESS syndrome that deteriorated rapidly up on tapering steroid therapy and was dramatically improved on combination of pulse steroid therapy and N-acetylcysteine. This case report may suggest that higher doses and gradual tapering of corticosteroid is a wise approach for using this type of therapy in DRESS syndrome. In addition it emphasizes the possible beneficial role of N-acetylcysteine in the therapy of this condition
机译：DRESS综合征（伴有嗜酸性粒细胞增多和全身症状的药物反应）是一种严重且危及生命的药物反应，其特征是发烧，皮疹，外周嗜酸性粒细胞增多，外周血涂片中存在非典型淋巴细胞，全身性淋巴结病和其他身体器官受累。文献中唯一同意的DRESS综合征疗法是扣留罪魁祸首药物。没有在这种情况下使用类固醇的对照试验。皮质类固醇的最佳剂量，治疗持续时间及其对死亡率的影响尚不清楚。可以用一只手手指数出有关在DRESS综合征中使用N-乙酰半胱氨酸的报道。在本文中，我们报道了一例严重的DRESS综合征，该疾病在逐渐减少的类固醇治疗中迅速恶化，而在脉冲类固醇治疗和N-乙酰半胱氨酸联合使用后显着改善。该病例报告可能表明，在DRESS综合征中使用此类治疗方法是较高剂量并逐渐减少皮质类固醇激素。另外，它强调了N-乙酰半胱氨酸在这种疾病的治疗中可能的有益作用。

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