Clinical Analysis Of 36 Cases Of Drug Hypersensitivity Syndrome

Objective:Drug Hypersensitivity Syndrome(DHS) is a severe and threatening systemic reaction triggered by a drug. This article is intended to study the clinical feature of DHS patients,as well as their diagnosis and treatment measures.Methods:We were retrospectively analyzed clinical records of 36 patients treated in The First Affiliated Hospital of Fujian Medical University dermatology with a diagnosis of DHS from January 2010 to December 2015.Results:From 2010 to 2015, in The First Affiliated Hospital of Fujian Medical University females with DHS slightly more than males, the ratio was 1:1.14, mainly distributed in the elderly, and gender in different age groups had no significant difference(P> 0.05). For six years, the incidence rates were 0.025, 0.075, 0.075, 0.15, 0.275, 0.3(Population base calculated at 40 million), had increased year by year. In this research, the most common culprit drugs of DHS were gout suppressants, antiepileptic drugs, antibiotics and antipyretic analgesic drugs. Allopurinol is the clear single consistent sensitive drugs induced DHS in the lead, followed by carbamazepine. DHS had a long incubation period, but there had no significant difference between gout suppressants or antiepileptic drugs induced DHS(P> 0.05). Fever and liver function damage were most common to be seen. However, facial swelling, the emergence of heterotypic lymphocytes is characterized in DHS. Mucosal damage in DHS is lighter, more involvement of the oral mucosa, rarely of conjunctiva and genital mucosal erosion. As for the different drug-induced kidney damage, increased BUN and creatinine in the allopurinol-induced DHS were more pronounced(P< 0.05). All patients received therapy of systemic glucocorticoid, 27 of 36 patients recovered, improved in 5 patients, 4 cases were discharged automatically(2 of them for concurrent double pneumonia and respiratory failure; the other were automatic discharge turned to the local treatment), no patients died in hospital, the efficiency of treatment is 88.89%.In addition, the relationships of ALT, AST, stop progress days and total hospitalization days to effective total-dose were proportional(R> 0, P< 0.05), not as age, fever, WBC, E, Cr(P> 0.05).Conclusion: 1. The incidence of DHS increased year by year.2. In this research, the most common culprit drugs of DHS were gout suppressants, antiepileptic drugs, antibiotics and antipyretic analgesic drugs.3. The renal dysfunction in gout suppressants induced DHS was more common than antiepileptic drugs.4. Fever and liver function damage were most common to be seen. However, facial swelling, the emergence of heterotypic lymphocytes is characterized in DHS.5. Glucocorticoid is the preferred drug for the treatment of DHS, and it uses in combination with IVIg can quickly control of disease progression and to improve the prognosis.