西妥昔单抗致大疱性药疹及口腔黏膜损害

• 作 者: 江灏 陈英 何菊英
• 机 构: 第三军医大学西南医院药学部,第三军医大学训练部,
• 出 处: 药物不良反应杂志
• 发表日期: 2013年03期
• 关键词: Cetuximab Bullous rash Oral mucosa injury

1例56岁男性患者,因鼻咽癌行放疗+西妥昔单抗分子靶向治疗。首次静脉滴注西妥昔单抗600 mg,此后400 mg/次,1次/周。首次用药后第11天患者面部及胸背部出现红色斑丘疹,并伴有脓疱,同时口腔黏膜红肿。给予氯雷他定抗过敏,呋喃西林溶液漱口。第4次用药开始将西妥昔单抗剂量减为300 mg,症状未见好转,患者出现口腔溃疡,舌体呈“地图”样改变,伴颈部皮肤糜烂。加用碳酸氢钠溶液漱口并给予抗感染等治疗。共用药6次后停用西妥昔单抗。停药后约6周患者皮肤、口腔黏膜损伤好转。

A 56-year-old man with radiotherapy for nasopharyngeal carcinoma + molecular targeted therapy with cetuximab. The first intravenous infusion of cetuximab 600 mg, 400 mg / time thereafter, 1 time / week. On the 11th day after the first administration, red rash appeared on the face, chest and back of the patient accompanied by pustules and oral mucosa was swollen. Give loratadine anti-allergy, nitrofurazone solution gargle. The fourth dose of cetuximab began to reduce the dose of 300 mg, the symptoms did not improve, patients with oral ulcers, tongue showed “map ” like changes, with cervical skin erosion. Add gargle with sodium bicarbonate solution and give anti-infective treatment. Cetuximab was discontinued after 6 doses were given. About 6 weeks after stopping the patient’s skin, oral mucosal injury improved.