Zusammenfassung
Unerwünschte Arzneimittelwirkungen (UAW) treten bei nahezu 10% der stationär und etwa 1,5% der ambulant behandelten Kinder auf. Mit einem Anteil von 20% an allen UAW betreffen Arzneimittelüberempfindlichkeitsreaktionen am häufigsten das Organ Haut. Aufgrund ihrer pathophysiologischen Heterogenität und der hieraus folgenden morphologischen Vielfalt stellen sie oft eine klinische und therapeutische Herausforderung dar. Urtikarielle und makulopapulöse Exantheme bedürfen nach Absetzen des inkriminierten Arzneimittels nur selten einer systemischen Therapie oder stationären Überwachung. Beim Auftreten polymorpher, mit Fieber und Lymphadenopathie assoziierter Arzneimittelexantheme sowie bei bullösen Hautveränderungen und/oder Schleimhautbeteiligung sollte jedoch eine extrakutane Symptomatik gezielt ausgeschlossen werden. Hiervon betroffene Patienten bedürfen in der Regel einer stationären Überwachung und interdisziplinären Supportivtherapie.
Abstract
Adverse drug reactions (ADR) occur in nearly 10% of hospitalized children and in about 1.5% of ambulatory pediatric patients. The skin is the most frequently affected target organ in drug hypersensitivity (DH) reactions, which account for 20% of all ADR. Due to its pathophysiological heterogeneity and the ensuing morphological diversity, DH often represents a clinical and therapeutic challenge. Urticarial and maculopapular eruptions are usually restricted to the skin and rarely require systemic treatment or hospital admission once the culprit drug has been withdrawn. However, extracutaneous affections should be ruled out promptly in individuals with polymorphous rashes accompanied by fever and lymphadenopathy as well as in patients with bullous skin lesions. Children affected by severe drug reactions usually require in-hospital surveillance and interdisciplinary supportive therapy.
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Dieser Beitrag wurde in Monatsschrift Kinderheilkunde Heft 11/2011 erstpubliziert.
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Ott, H. Kutane Arzneimittelreaktionen im Kindes- und Jugendalter. Hautarzt 63, 97–103 (2012). https://doi.org/10.1007/s00105-011-2197-7
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DOI: https://doi.org/10.1007/s00105-011-2197-7
Schlüsselwörter
- Arzneimittelallergie
- DRESS
- Stevens-Johnson-Syndrom
- Toxische epidermale Nekrolyse
- Serumkrankheitähnliche Reaktion