背景:据报道,乙醇肟和其他抗癫痫药物会引起特殊反应,例如狼疮样综合征,抗核抗体(ANA)水平升高。在这里,我们介绍了一个女孩谁发展了一个非常严重的雷诺现象反应和抗Scl-70抗体与治疗相关的乙苏肟,由于青少年失神癫痫(JAE)。
方法:一名12岁女孩被诊断为JAE,并开始接受乙肟治疗。两个半月后她的手指,双侧数字II-V,开始疼痛,变色,交替白色,蓝色,或正常颜色。两周后,她的手指是蓝黑色的,疼痛严重,几乎连续。一家人寻求医疗建议。由于严重的症状,停用了乙苏肟,开始使用泼尼松龙和静脉注射伊洛前列素治疗。实验室测试显示具有抗Scl-70模式的高ANA水平并确认抗Scl-70抗体。几周后,她开始好转,症状在五个月内慢慢减轻。抗Scl-70在症状出现四个月后仍然可以检测到,虽然她进步了很多。十一个月后,重复的ANA分析为完全阴性.
结论:虽然极为罕见,重要的是要认识到严重的雷诺现象,威胁外围数字流通,可能是对乙肟的特殊反应,引起对血管炎可能发作的关注。
BACKGROUND: Ethosuximide and other anti-epileptic drugs have been reported to cause idiosyncratic reactions such as lupus-like syndromes, with elevated antinuclear antibody (ANA) levels. Herein, we present a
case of a girl who developed a very severe Raynaud\'s phenomenon reaction and anti-Scl-70 antibodies related to treatment with ethosuximide, due to juvenile absence epilepsy (JAE).
METHODS: A 12-year-old girl was diagnosed with JAE and treatment with ethosuximide was initiated. Two and a half months later her fingers, digits II-V bilaterally, began to ache and were discolored, alternatingly white, blue, or normal-colored. Two weeks later, her fingers were bluish-black, aching severely, almost continuously. The family sought medical advice. Ethosuximide was halted and due to the severe symptoms, treatment with both prednisolone and intravenous iloprost was commenced. Laboratory tests revealed high ANA levels with anti-Scl-70 pattern and confirmed anti-Scl-70 antibodies. After a few weeks, she started to improve and the symptoms slowly decreased over five months. Anti-Scl-70 was still detectable four months after onset of symptoms, though she was much improved. After eleven months, repeated ANA analyses were completely negative.
CONCLUSIONS: Although extremely rare, it is important to recognize that severe Raynaud\'s phenomenon, threatening peripheral digital circulation, may occur as an idiosyncratic reaction to ethosuximide, raising concern over possible onset of vasculitis.