Adverse Drug Reactions Journal 2017;19(6):475-477

doi:10.3760/cma.j.issn.1008-5734.2017.06.019

Acute generalized exanthematous pustulosis caused by Xuesaitong for injection(注射用血塞通)

Haifei WANG 1 ; Guoping SUN 1

Affiliations

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Keywords

Acute generalized exanthematous pustulosis; Xuesaitong for injection

Country

China

Language

Chinese

Abstract

A 61-year-old female patient received an IV infusion of Xuesaitong for injection 400 mg once daily for 6 days after the resection of left popliteal cyst. The next day after the drug withdrawal,She developed systemic rashes with itching and IV infusion of dexamethasone 10 mg once daily and oral chlorpheniramine 4 mg thrice daily were given. The symptoms were not improved after 7 days of treatments. On day 8,dexamethasone and chlorpheniramine were stopped,IV infusion of methylprednisolone 55 mg once daily and oral levocetirizine,cimetidine,potassium chloride sustained-release tablets were given. On day 10,the patient developed new eruption on the back,diffuse edematous erythema on the trunk and limbs,with light yellow pustules on erythema and part of pustules merging into sheet. According to the result of histopathological examination on the rash of the abdomen skin,acute generalized exanthematous pustulosis was considered. After that,the patient′s condition was improved,glucocorticoids was used continuously and the dosage was reduced gradually,while stomach-protective drugs and external use of skin treatment were given at the same time. On day 18,the dose of intravenous infusion of methylprednisolone was reduced to 20 mg once daily and oral methylprednisolone 12 mg once daily was given. On day 32, oral methylprednisolone was stopped. On day 37,new eruption appeared on the patient′s back,intramuscular injection of compound betamethasone injection 1 mg was given at one time,oral compound glycyrrhizin 80 mg and tripterygium glycosides 20 mg were given thrice daily. On day 50,the skin rashes darkened, pustules disappeared basically,no edema and new rash appeared. Methylprednisolone sodium succinate was stopped and changed to oral methylprednisolone tablets 20 mg once daily. Oral methylprednisolone was gradually reduced to 2 mg once daily and about 4. 5 months later,the rashes subsided completely, methylprednisolone was stopped.