严重的DRESS与肌肉性心脏炎二次性纳普罗森/异索普拉
Sarah O'Mahony1,2, Ann-Marie Tobin3,2, Teresa Mary Donnelly4
1Dermatology, Tallaght University Hospital, Dublin, Ireland seomahon@tcd.ie.
BMJ case reports
|April 9, 2024
概括
一种罕见的药物反应与乙酸和全身症状 (DRESS) 导致严重的心脏问题,包括心肌炎,在一个患者服用纳普罗森/esomeprazole. 迅速戒药和治疗导致了康复.
科学领域:
- 心脏病学 心脏病学
- 皮肤病学 皮肤病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 药物反应与埃索诺菲利亚和系统性症状 (DRESS) 是一种严重的,特异性的过敏反应.
- 心脏并发症是DRESS综合征的一个罕见但严重的表现.
- 纳普罗森/以索莫普拉是DRESS的一个不常见的触发因素.
研究的目的:
- 报告一个罕见的DRESS综合征病例,伴有心脏并发症.
- 强调在服装中识别心脏表现的重要性.
- 突出及时诊断和管理在改善患者治疗结果中的作用.
主要方法:
- 一个男性患者的病例介绍,在开始服用纳普罗森/异索普拉后,他出现了广泛的皮疹,高氨酸和急性损伤.
- 诊断工作包括血液检查,皮肤活检,冠状动脉血管学和心脏MRI.
- 治疗包括药物停用和口服皮质类固醇的支持性护理.
主要成果:
- 患者患有急性冠状动脉综合征和快速心房,归因于DRESS诱导的心肌炎,由心脏MRI证实.
- 组织病理学揭示了帕拉基拉托斯,轻微的海绵病和埃索诺菲尔.
- 在治疗后,重复的心脏MRI显示肌心炎在3个月内消失.
结论:
- 这一案例强调了DRESS综合征中可能出现严重的心脏并发症,包括心肌炎.
- 早期识别和撤销违规剂 (在这种情况下是naproxen/esomeprazole) 是至关重要的.
- 及时治疗可以带来有利的心脏恢复,尽管已知与DRESS相关的高死亡率.
更多相关视频
相关概念视频
Antianginal Drugs: Nitrates and β-Blockers
579
In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow....
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow....
579
Other Disorders of Digestive System
825
The gastrointestinal tract is susceptible to various disorders. If the lower esophageal sphincter is damaged, stomach acid can flow back into the esophagus, causing irritation and inflammation of the lining. This condition is called gastroesophageal reflux disease (known as heartburn) and may cause chest pain and difficulty swallowing. In the stomach, prolonged use of nonsteroidal anti-inflammatory drugs like aspirin, chronic alcohol consumption, bacterial infections such as Helicobacter...
825
Imaging Studies for Cardiovascular System I:Echocardiography
320
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
320
Esophageal Strictures-I: Introduction
88
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
88
Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
436
Histamine H2 receptors, which are intricately located on the basolateral membrane of parietal cells, play a crucial role in modulating gastric acid secretion. When released from enterochromaffin-like cells, histamine engages H2 receptors, initiating the cyclic AMP (cAMP) pathway. In this pathway, adenylyl cyclase converts ATP into cAMP, elevating intracellular cAMP levels. The activation of protein kinase A follows, stimulating the proton pump. This stimulation prompts the secretion of hydrogen...
436
Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
392
Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
392


