摘要：
A 22﹣year﹣old female patient received methylprednisolone sodium succinate( methyl﹣prednisolone)for injection( 1 000 mg/d for 3 days and gradually reduced to 60 mg/d for maintenance therapy,IV infusion),immunoglobulin( 20 g/d,IV infusion),mouse nerve growth factor( 20 μg/d, intramuscular injection),vitamin B1(100 mg/d,intramuscular injection),and mecobalamin(1 mg/d,IV injection)for multiple sclerosis. Twelve days later,mouse nerve growth factor was temporarily discontinued and 7 days later,the drug was given again. On day 2 of retreatment,the patient developed conjunctival congestion. On day 3 of retreatment,red spots appeared on her chest,back,abdomen,and forearms. Then the rashes gradually increased,linked into pieces,and spread all over the body. Rashes partly formed blisters,blisters ulcerated,and epidermis exfoliated. It was considered that mouse nerve growth factor induced the toxic epidermal necrolysis. Then the drug was discontinued,the dose of methylprednisolone was increased to 500 mg/d,and at the same time,immunoglobulin,desloratadine,and fexofenadine were given. Twenty days later,the rashes subsided and pigmentation remained.%1例22岁女性患者因多发性硬化接受注射用甲泼尼龙琥珀酸钠(甲泼尼龙,1 000 mg/d静脉滴注3 d,后逐渐减量至60 mg/d维持治疗)、免疫球蛋白(20 g/d 静脉滴注)、鼠神经生长因子(20 μg/d 肌内注射)、维生素B1(100 mg/d 肌内注射)和甲钴胺(1 mg/d 静脉注射)等治疗.12 d后暂停鼠神经生长因子.停药7d后再次使用鼠神经生长因子,第2天,患者出现结膜充血;第3天,胸、背部、腹部及双前臂出现红色斑疹.随后皮疹逐渐增多,连接成片,遍布全身,部分皮疹形成水疱,水疱破溃,表皮松解剥脱.考虑为鼠神经生长因子所致中毒性表皮坏死松解型药疹.停用该药,甲泼尼龙用量加至500 mg/d,同时联用免疫球蛋白、地氯雷他定、非索非那定等.20 d后,全身皮疹消退,留有色素沉着.
