Carbamazepine引起Stevens-Johnson症候群個案報告

這是一個23歲單身男性，因情感性精神病，躁症而入院治療，在服用Carbamazepine的第12天開始出現類似上呼吸道感染之症狀包括倦怠感、喉嚨痛、發燒、發冷、咳嗽等，3天後臉部、四肢及軀幹都有皮膚疹；兩唇、口腔黏膜及舌頭皆有潰瘍，結膜炎、中耳炎、尿道炎及咽喉炎亦陸續被發現，稍後皮膚疹彌漫全身且漸呈斑疹丘疹狀，部份斑疹丘疹的中央有一小水疱或表皮壞斑。經照會傳染病科及皮膚科檢查後確定為Stevens-Johnson症候群。在皮膚疹出現的當天即停用Carbamazepine；並給予支持性療法及抗生素治療13天後，上述症狀完全康復，只是部份皮膚留下色素過度沈積現象（hyperpigmentation）。本報告說明Carbamazepine除了會引起再生性不良貧血外另有一個嚴重且值得臨床醫師注意的副作用。作者建議對於服用Carbamazepine的病人，在服藥的一至三週內應密切關察其是否有類似上呼吸道感染的徵兆，必要時得馬上停藥，並給予支持性治療以減少這種罕見却會致命的副作用。

關鍵字

Stevens-Johnson症候群

並列摘要

Stevens-Johnson syndrome is a clinical entity, characterized by distinctive skin lesion, severe mucosal involvement, and often severe systemic symptoms. The syndrome in now generally classified as a severe form of erythema multiforme. There are many etiologic associations including drugs and infections; however, the pathophysiology of the syndrome remains obscure. Treatment at present is symptomatic and supportive. Although frequently used, the beneficiaI role of corticosteroids in this syndrome remains to be proved. The case report describes a young man who after treatment with Carbamazepine (Tegretol) developed the Stevens-Johnson syndrome. We include a brief review of the Iiterature and emphasis that closed observation of possible infectious signss in the early stage of Carbamazepine therapy is highly indicated.

並列關鍵字

Carbamazpine ； Stevens-Johnson syndrome

國際替代計量

Carbamazepine引起Stevens-Johnson症候群個案報告

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