磷酸西格列汀致大疱性类天疱疮

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1例70岁男性2型糖尿病患者因血糖控制不佳,在既往口服盐酸二甲双胍治疗的基础上加用磷酸西格列汀(西格列汀)。用药16 d后,患者四肢出现红斑和水疱,伴瘙痒。实验室检查:白细胞计数12.2×10n 9/L,中性粒细胞计数8.5×10n 9/L,嗜酸粒细胞计数4.56×10n 9/L。皮损处组织病理学检查示表皮下水疱,疱顶为完整表皮,疱底为真皮乳头,疱内可见浆液及嗜酸性细胞,疱下真皮浅层有少量嗜酸粒细胞浸润。诊断为大疱性类天疱疮,考虑可能与西格列汀有关。停用西格列汀,1周后红斑和水疱逐渐消退,无新发红斑和水疱。n “,”A 70-year-old male patient with type 2 diabetes mellitus was treated with sitagliptin phosphate (sitagliptin) on the basis of previous oral metformin hydrochloride due to poor glycemic control. After 16 days of medication, the patient developed erythema and blisters with itching on the skin of the limbs. Laboratory tests showed that the white blood cell count was 12.2×10n 9/L, neutrophil count was 8.5×10n 9/L, and eosinophil count was 4.56×10n 9/L. Histopathological examination of the skin lesion showed blisters under the epidermis, intact epidermis at the top of the blisters, dermal papillae at the bottom of the blisters, serous fluid and eosinophils in the blisters, and slight infiltration of eosinophils in the superficial dermis under the blisters. Bullous pemphigoid was diagnosed, which was considered to be related to sitagliptin. Therefore, the drug was discontinued. One week later, erythema and blisters gradually disappeared and no erythema or blisters recured.n
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