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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Severe DRESS Syndrome Managed With Therapeutic Plasma Exchange
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Severe DRESS Syndrome Managed With Therapeutic Plasma Exchange

机译：血浆置换治疗严重的DRESS综合征

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摘要

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but increasingly described phenomenon of immune activation and organ dysfunction in association with a wide variety of medications. This reaction shows a broad spectrum of clinical presentation and severity, ranging from mild to lethal. Treatment strategies of immune suppression appear be helpful in some cases, but treatment failures occur frequently with reported mortality rates of 5% to 10%. We present a pediatric case of DRESS syndrome associated with either lamotrigine or bupropion, leading to multiorgan involvement and life-threatening complications of respiratory failure and cardiac arrest. After failing to improve with removal of these medications and administration of systemic corticosteroids, our patient showed dramatic, sustained clinical response to therapeutic plasma exchange. To our knowledge, this is the first reported case of therapeutic plasma exchange used for life-threatening DRESS syndrome in a pediatric patient. This case suggests needed research for this therapeutic option in life-threatening DRESS syndrome resistant to high-dose steroids. Pediatrics 2013;131:e945-e949
机译：嗜酸性粒细胞增多和全身症状（DRESS）综合征的药物反应是一种罕见的但越来越多地描述的免疫激活和器官功能障碍的现象，与多种药物相关。该反应显示出广泛的临床表现和严重程度，从轻度到致命。免疫抑制的治疗策略在某些情况下可能会有所帮助，但是治疗失败经常发生，据报道死亡率为5％至10％。我们介绍了小儿DRESS综合征的病例，该病例与拉莫三嗪或安非他酮有关，导致多器官受累以及呼吸衰竭和心脏骤停的危及生命的并发症。在因去除这些药物和全身性皮质类固醇而无法改善症状后，我们的患者对治疗性血浆置换表现出了惊人的持续临床反应。据我们所知，这是第一例报道的治疗性血浆置换用于小儿患者生命危险的DRESS综合征的病例。该病例表明，对于对高剂量类固醇耐药的威胁生命的DRESS综合征，该治疗方案需要进行研究。儿科2013; 131：e945-e949

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