{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T04:48:41Z","timestamp":1754110121735},"reference-count":0,"publisher":"Akademiai Kiado Zrt.","issue":"46","license":[{"start":{"date-parts":[[2020,11,15]],"date-time":"2020-11-15T00:00:00Z","timestamp":1605398400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2020,11,15]]},"abstract":"\u00d6sszefoglal\u00f3.<\/jats:bold> K\u00e9t fiatal n\u0151betegn\u00e9l a valpro\u00e1tr\u00f3l lamotriginre\n t\u00f6rt\u00e9n\u0151 gy\u00f3gyszer\u00e1t\u00e1ll\u00edt\u00e1s sor\u00e1n a 3\u20134. h\u00e9ten influenzaszer\u0171 prodromalis\n t\u00fcneteket k\u00f6vet\u0151en toxikus epidermalis necrolysis (TEN), m\u00e1s n\u00e9ven\n Lyell-szindr\u00f3ma alakult ki. Mindk\u00e9t beteg 5 napja kezd\u0151d\u00f6tt b\u0151r- \u00e9s\n ny\u00e1lkah\u00e1rtyat\u00fcnetekkel, kiterjedt h\u00e1mlev\u00e1l\u00e1st okoz\u00f3 h\u00e1mnekr\u00f3zissal ker\u00fclt\n felv\u00e9telre a Debreceni Egyetem B\u0151rgy\u00f3gy\u00e1szati Klinik\u00e1j\u00e1nak \u00c9g\u00e9si Intenz\u00edv\n Oszt\u00e1ly\u00e1ra. Multidiszciplin\u00e1ris szupport\u00edv ter\u00e1pia mellett nagy d\u00f3zis\u00fa szteroid-\n \u00e9s immunglobulin-ter\u00e1pi\u00e1t alkalmaztunk. A 37 \u00e9ves n\u0151betegn\u00e9l 3 h\u00e9t ut\u00e1n a k\u00f3rk\u00e9p\n fat\u00e1lis kimenetellel v\u00e9gz\u0151d\u00f6tt. A 19 \u00e9ves n\u0151beteg t\u00fcnetei 4 h\u00e9t intenz\u00edv ter\u00e1pia\n ut\u00e1n sz\u00f6v\u0151dm\u00e9nyekkel gy\u00f3gyultak. A TEN ritka, gy\u00f3gyszer \u00e1ltal okozott, \u00e9letet\n vesz\u00e9lyeztet\u0151, k\u00e9s\u0151i hiperszenzitivit\u00e1si reakci\u00f3. Patogenezis\u00e9ben a\n gy\u00f3gyszermolekula, a hum\u00e1n leukocytaantig\u00e9n (HLA) I. oszt\u00e1ly\u00fa molekula \u00e9s a\n T-sejt-receptor k\u00f3ros interakci\u00f3ja szerepel. Kezel\u00e9s\u00e9ben a legfontosabb a\n kiv\u00e1lt\u00f3 gy\u00f3gyszer elhagy\u00e1sa, valamint az azonnal kezdett komplett szupport\u00edv\n ter\u00e1pia alkalmaz\u00e1sa. A specifikus kezel\u00e9st illet\u0151en nincsenek egys\u00e9ges szakmai\n ir\u00e1nyelvek. A vesz\u00e9lyes gy\u00f3gyszerek titr\u00e1lt bevezet\u00e9se cs\u00f6kkentheti a kialakul\u00f3\n hiperszenzitivit\u00e1s s\u00falyoss\u00e1g\u00e1t, ezenfel\u00fcl a beteg szoros k\u00f6vet\u00e9se \u00e9s az adverz\n t\u00fcnetek korai felismer\u00e9se jav\u00edthatja a TEN kimenetel\u00e9t. Orv Hetil. 2020;\n 161(46): 1959\u20131965.<\/jats:p>\n Summary.<\/jats:bold> After switching from valproate to lamotrigine, on the\n 3rd\u20134th weeks, two young female patients developed flu-like prodromal symptoms,\n followed by the development of toxic epidermal necrolysis (TEN), also known as\n Lyell syndrome. Both patients were admitted to the Burn Intensive Care Unit of\n the Department of Dermatology, University of Debrecen with skin and mucosa\n symptoms; extensive epithelial death and detachment started 5 days earlier. In\n addition to multidisciplinary supportive treatment, high-dose corticosteroid and\n immunoglobulin therapy were administered. In the case of the 37-year-old female\n patient, the disease resulted in a fatal outcome. The 19-year-old patient healed\n with some sequelae. TEN is a rare, life-threatening delayed-type\n hypersensitivity reaction caused by drugs. Its pathogenesis involves an\n interaction between small-molecule drug, human leukocyte antigen class I\n molecule and T-cell receptor. The most important treatment is immediate\n withdrawal of potentially causative drugs and prompt application of supportive\n therapy. There is no standard guidance on specific treatment. Slow dose\n escalation of dangerous drugs can be beneficial in avoiding severe reactions,\n furthermore, close patient follow-up and early detection of the possible adverse\n reactions contribute to a more favourable outcome of TEN. Orv Hetil. 2020;\n 161(46): 1959\u20131965.<\/jats:p>","DOI":"10.1556\/650.2020.31888","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T05:18:03Z","timestamp":1605676683000},"page":"1959-1965","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":2,"title":["Sz\u00e1m\u00edt-e a gy\u00f3gyszer d\u00f3zisa a t\u00fal\u00e9rz\u00e9kenys\u00e9gi reakci\u00f3kban?"],"prefix":"10.1556","volume":"161","author":[{"given":"Lenke","family":"Jenei Kluch","sequence":"first","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, B\u0151rgy\u00f3gy\u00e1szati Klinika, Debreceni Egyetem, Debrecen"},{"name":"2 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Klinika, Debreceni Egyetem, Debrecen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ir\u00e9n","family":"Erdei","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, B\u0151rgy\u00f3gy\u00e1szati Klinika, Debreceni Egyetem, Debrecen"},{"name":"2 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Klinika, Debreceni Egyetem, Debrecen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9va","family":"Remenyik","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, B\u0151rgy\u00f3gy\u00e1szati Klinika, Debreceni Egyetem, Debrecen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9va","family":"Sur\u00e1nyi","sequence":"additional","affiliation":[{"name":"3 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Szem\u00e9szeti Klinika, Debreceni Egyetem, Debrecen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferenc","family":"Bodn\u00e1r","sequence":"additional","affiliation":[{"name":"4 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, K\u00f3rh\u00e1zhigi\u00e9n\u00e9s Oszt\u00e1ly, Debreceni Egyetem, Debrecen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Emri","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, B\u0151rgy\u00f3gy\u00e1szati Klinika, Debreceni Egyetem, Debrecen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Szegedi","sequence":"additional","affiliation":[{"name":"1 \u00c1ltal\u00e1nos Orostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, B\u0151rgy\u00f3gy\u00e1szati Klinika, Debreceni Egyetem, Debrecen"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","container-title":["Orvosi Hetilap"],"original-title":[],"link":[{"URL":"https:\/\/akjournals.com\/view\/journals\/650\/161\/46\/article-p1959.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/650\/161\/46\/article-p1959.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T01:13:18Z","timestamp":1633914798000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/view\/journals\/650\/161\/46\/article-p1959.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,15]]},"references-count":0,"journal-issue":{"issue":"46"},"URL":"https:\/\/doi.org\/10.1556\/650.2020.31888","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,15]]}}}