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目的:探讨小儿抗癫痫药物过敏反应综合征的诊断、治疗及预后。方法:对1995年5月～2002年4月我院收住的11例患儿的临床资料及随访结果进行分析。结果:11例患儿均有发热、皮疹、粘膜损害、皮肤脱屑及色素沉着,其中肝脏损害7例,淋巴结肿大4例,心、肾受累各4例,骨髓受累2例,表现为Stevens—Johnson综合征1例,皮质激素治疗均有效,内脏损害均为可逆性,7例随访半年,除有皮肤色素沉着外无其他异常表现。7例需继续用抗癫痫药物治疗者,改用丙戊酸钠5例,托吡酯2例,未再出现过敏及癫痫发作。结论:抗癫痫药物过敏反应综合征多发生于服用抗癫痫药物后1～6周,通常表现为发热、皮疹与内脏器官受累三联征,应引起临床医师的高度重视。
Objective: To investigate the diagnosis, treatment and prognosis of children with antiepileptic drugs allergic reaction syndrome. Methods: The clinical data and follow-up results of 11 cases admitted to our hospital from May 1995 to April 2002 were analyzed. Results: All of the 11 children had fever, rash, mucosal damage, skin desquamation and pigmentation. Among them, hepatic injury was found in 7 cases, lymph node enlargement in 4 cases, heart and kidney involvement in 4 cases, and bone marrow involvement in 2 cases. Johnson Johnson syndrome in 1 case, corticosteroids were effective, visceral lesions were reversible, 7 cases were followed up for six months, with the exception of skin pigmentation and no other abnormalities. 7 cases need to continue treatment with antiepileptic drugs, switch to sodium valproate in 5 cases, 2 cases of topiramate, no recurrence of allergies and seizures. Conclusion: Antiepileptic drugs hypersensitivity syndrome occurs mostly in 1 ~ 6 weeks after taking antiepileptic drugs. It usually shows fever, rash and triad of organ involvement, which should be paid more attention by clinicians.