Strontium Ranelate造成史蒂文生氏－強生症候群案例報告

Strontium ranelate是臺灣市面上唯一具有抑制破骨細胞活性與促進成骨細胞活性的藥品，適應症為停經後婦女骨質疏鬆症之治療，以降低脊椎骨折與髖骨骨折的風險。嚴重皮膚過敏反應包括史蒂文生氏—強生症候群，毒性表皮溶解症在文獻上皆有案例報告。本文探討一位82歲女性，有失智症，入院診斷為左側髖骨轉子間骨折以閉鎖式復位內固定，轉骨科門診追蹤開立strontium ranelate 2 g每日一次，約一個多月後臉、四肢出現紅疹，黏膜破損含嘴唇、眼睛至皮膚科醫師診斷為史蒂文生氏—強生症候群，轉住院期間給與注射類固醇及症狀治療，6天後狀況穩定改門診追蹤。提醒病人應注意此嚴重皮膚藥物不良反應，並衛教病人如果出現包括皮疹、起水泡、黏膜損傷、發燒的徵兆或症狀，需立即停藥並就醫診治，一般病人預後良好。

關鍵字

Strontium Ranelate ；骨質疏鬆症；嚴重皮膚藥物不良反應；史蒂文生氏－強生症候群

並列摘要

Among the drugs approved in Taiwan to treat osteoporosis, strontium ranelate has a unique mode of action in that it affects both bone resorption and bone formation. In postmenopausal women with osteoporosis, strontium ranelate reduces the risk of vertebral and hip fractures. Severe cutaneous adverse reactions in patients receiving strontium ranelate have been reported, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). We report the case of an 82-year-old woman with dementia who received strontium ranelate for treatment of osteoporosis after undergoing closed reduction with internal fixation for left side intertrochanteric fracture. One month later, she developed atypical target lesions on the face, trunk, and limbs with mucosal involvement of the lips and eyes. After admission, systemic methylprednisolone was administered and her condition gradually improved. Patients taking strontium ranelate should be advised of the signs and symptoms of and be monitored closely for skin reactions (specifically, progressive cutaneous rash, blisters, mucosal involvement, or fever); strontium ranelate treatment should be discontinued immediately in affected patients. With prompt treatment, patients receiving strontium ranelate who experience severe cutaneous drug reactions have a good prognosis.

並列關鍵字

Strontium Ranelate ； Osteoporosis ； Severe Cutaneous Adverse Reaction ； Stevens-Johnson Syndrome

國際替代計量

Strontium Ranelate造成史蒂文生氏－強生症候群案例報告

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