拉莫三嗪严重免疫相关不良反应文献分析

中国药物警戒 ›› 2018, Vol. 15 ›› Issue (10): 603-607.

拉莫三嗪严重免疫相关不良反应文献分析

邱波¹, 周娟², 田月洁^3*

¹济南市第三人民医院,山东济南 250132;
²山东省血液中心,山东济南 250000;
³山东省药品不良反应监测中心,山东济南 250014

收稿日期:2018-09-18 修回日期:2018-11-27 出版日期:2018-10-20 发布日期:2018-11-27
通讯作者: 田月洁,男,硕士,主任药师,药品不良反应监测与评价。E-mail:tianyuejie@shandong.cn
作者简介:邱波,男,本科,副主任药师,药学。

Literature Analysis of the Serious Immune-related Adverse Reactions of Lamotrigine

QIU Bo¹, ZHOU Juan², TIAN Yuejie^3*

¹Jinan Third People's Hospital, Shandong Jinan 250132, China;
²Blood Center of Shandong Province, Shandong Jinan 250000, China;
³Shandong Center for Adverse Drug Reaction Monitoring, Shandong Jinan 250014, China

Received:2018-09-18 Revised:2018-11-27 Online:2018-10-20 Published:2018-11-27

摘要/Abstract

摘要： 目的分析拉莫三嗪引起的严重免疫相关不良反应,为临床安全用药提供参考。方法系统检索国内外文献报道的相关不良反应个例、综述、研究等,综述拉莫三嗪引起严重免疫相关不良反应的表现、特征、发生机制。结果拉莫三嗪可引起严重免疫相关不良反应,包括Stevens-Johnson 综合征、中毒性表皮坏死松解症、伴嗜酸性粒细胞增多和系统症状的药物反应、免疫性溶血性贫血、系统性红斑狼疮、假性淋巴瘤、边缘性脑炎以及噬血细胞性淋巴组织细胞增生症等。发生时间从用药后几天到数年不等。不同免疫相关不良反应具有不同的发生机制,有的不良反应罕见但非常严重甚至致命。结论医务人员应关注拉莫三嗪严重免疫相关不良反应风险,及时诊断治疗。建议生产企业加强研究,在说明书增加有关不良反应警示,避免严重后果发生。

Abstract: Objective To analyze the serious immune-related adverse reactions caused by lamotrigine and provide reference for the clinical rational drug use. Methods The related adverse reactions reported in domestic and foreign literatures were systematically retrieved, such as cases, reviews, studies, etc., and the manifestations, characteristics and mechanism of lamotrigine-induced severe immune-related adverse reactions were reviewed. Results Lamotrigine can cause serious immune-related adverse reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, immune hemolytic anemia, systemic lupus erythematosus, pseudolymphoma, limbic encephalitis, and hemophagocytic lymphohistiocytosis, occurring from a few days to several years after administration. Different immune-related adverse reactions have different mechanisms of occurrence, and some adverse reactions are rare but very severe or even fatal. Conclusion Medical staff should pay attention to the risk of serious immune-related adverse reactions of lamotrigine and timely diagnosis and treatment. It is recommended that manufacturers strengthen research and increase warnings about adverse reactions in the instructions to avoid serious consequences.

Key words: immune-related adverse reactions, lamotrigine, drug reaction with eosinophilia and systemic symptoms, systemic lupus erythematosus, hemophagocytic lymphohistiocytosis

中图分类号:

R994.11

邱波, 周娟, 田月洁. 拉莫三嗪严重免疫相关不良反应文献分析[J]. 中国药物警戒, 2018, 15(10): 603-607.

QIU Bo, ZHOU Juan, TIAN Yuejie. Literature Analysis of the Serious Immune-related Adverse Reactions of Lamotrigine[J]. Chinese Journal of Pharmacovigilance, 2018, 15(10): 603-607.

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