{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:11:53Z","timestamp":1761894713199},"reference-count":28,"publisher":"Akademiai Kiado Zrt.","issue":"19","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,5,1]]},"abstract":"<jats:p>Az adverz gy\u00f3gyszerreakci\u00f3k k\u00fcl\u00f6nf\u00e9le klinikai megjelen\u00e9si form\u00e1i alapj\u00e1n a kiv\u00e1lt\u00f3 gy\u00f3gyszerre neh\u00e9z k\u00f6vetkeztetni. A gyan\u00faba vett gy\u00f3gyszerek elhagy\u00e1sa ut\u00e1n fell\u00e9p\u0151 javul\u00e1s vagy az empirikus tapasztalat, esetleg irodalmi adatok alapj\u00e1n lehet a felel\u0151s gy\u00f3gyszert felt\u00e9telezni. A gy\u00f3gyszer\u00e9rz\u00e9kenys\u00e9g bizony\u00edt\u00e1sa bonyolult, j\u00f3l \u00e1tgondolt orvosi tev\u00e9kenys\u00e9g \u00fatj\u00e1n lehets\u00e9ges, \u00e9s azokban az esetekben sz\u00fcks\u00e9ges, amikor a gyan\u00fas gy\u00f3gyszer m\u00e1s vegy\u00fcletcsoportba tartoz\u00f3 szerrel nem helyettes\u00edthet\u0151, \u00e9s a betegnek felt\u00e9tlen\u00fcl sz\u00fcks\u00e9ges szednie. A jelen k\u00f6zlem\u00e9ny c\u00e9lja egy eset kapcs\u00e1n k\u00f6rvonalazni azokat a lehet\u0151s\u00e9geket \u00e9s vesz\u00e9lyeket, melyek a kivizsg\u00e1l\u00e1s sor\u00e1n alkalmazhat\u00f3k, illetve megjelenhetnek. A kivizsg\u00e1l\u00e1s sor\u00e1n haszn\u00e1lt m\u00f3dszerek a gyan\u00faba vett gy\u00f3gyszerekkel \u2013 lamotrigin, risperidon, sertralin \u2013 zopiclonum, atorvastatin elv\u00e9gzett epicutan teszt sor\u00e1n egyed\u00fcl a sertralin adott a multiform t\u00fcnetekkel azonos pozit\u00edv reakci\u00f3t. A pozit\u00edv b\u0151rteszt ter\u00fclet\u00e9r\u0151l k\u00e9sz\u00fclt hisztol\u00f3giai vizsg\u00e1lat eredm\u00e9nye visszautalt az eredetileg \u00e9szlelt klinikai form\u00e1ra (erythema exsudativum multiforme Stevens\u2013Johnson-szindr\u00f3ma). A beteg bipol\u00e1ris affekt\u00edv zavara miatt a negat\u00edv b\u0151rtesztet ad\u00f3 k\u00e9sz\u00edtm\u00e9nyekkel per os provok\u00e1ci\u00f3 t\u00f6rt\u00e9nt, ez azonban a beteg sz\u00e1m\u00e1ra kock\u00e1zatos, de az egyetlen megb\u00edzhat\u00f3 \u00e9s biztos m\u00f3dszer. Az elv\u00e9gzett per os expoz\u00edci\u00f3 sor\u00e1n a t\u00f6rzs\u00f6n a lamotrigint\u0151l m\u00e1r t\u00f6rt adag bev\u00e9tel\u00e9t k\u00f6vet\u0151en h\u00e1rom \u00f3r\u00e1n bel\u00fcl diff\u00faz erythema, 12 \u00f3r\u00e1n bel\u00fcl az alkalmazott szteroid- \u00e9s antihisztamin-kezel\u00e9s ellen\u00e9re scarlatiniform exanthema jelent meg. Az eset \u00e9rdekess\u00e9ge, hogy a gyan\u00faba vett gy\u00f3gyszerek sor\u00e1n epicutan teszttel egy gy\u00f3gyszer \u00e9rz\u00e9kenys\u00e9ge igazol\u00f3dott, azonban a m\u00e1sik gyan\u00faba vett k\u00e9sz\u00edtm\u00e9nnyel v\u00e9gzett pozit\u00edv per os expoz\u00edci\u00f3s pr\u00f3ba is v\u00e1ratlanul t\u00fcnetet provok\u00e1lt (scarlatiniform, azonnali reakci\u00f3t). Meg\u00e1llap\u00edthat\u00f3, hogy csup\u00e1n egy bizonyos m\u00f3dszer m\u00e9g a klinikai k\u00e9ppel val\u00f3 egyez\u0151 eredm\u00e9ny alapj\u00e1n sem elegend\u0151 adverz gy\u00f3gyszerreakci\u00f3 provok\u00e1l\u00f3 t\u00e9nyez\u0151j\u00e9nek bizony\u00edt\u00e1s\u00e1ra.<\/jats:p>","DOI":"10.1556\/oh.2008.28285","type":"journal-article","created":{"date-parts":[[2008,5,4]],"date-time":"2008-05-04T04:53:42Z","timestamp":1209876822000},"page":"883-887","source":"Crossref","is-referenced-by-count":2,"title":["Difficulties in the detection of the culprit drug for an adverse drug reaction in a complicated case"],"prefix":"10.1556","volume":"149","author":[{"given":"Henriette","family":"Kopcs\u00e1nyi","sequence":"first","affiliation":[{"name":"1 Pest Megyei Fl\u00f3r Ferenc K\u00f3rh\u00e1z B\u0151rgy\u00f3gy\u00e1szati Oszt\u00e1ly Kistarcsa Semmelweis t\u00e9r 1. 2143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julianna","family":"Feldmann","sequence":"additional","affiliation":[{"name":"1 Pest Megyei Fl\u00f3r Ferenc K\u00f3rh\u00e1z B\u0151rgy\u00f3gy\u00e1szati Oszt\u00e1ly Kistarcsa Semmelweis t\u00e9r 1. 2143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zs\u00f3fia","family":"P\u00e9ch","sequence":"additional","affiliation":[{"name":"1 Pest Megyei Fl\u00f3r Ferenc K\u00f3rh\u00e1z B\u0151rgy\u00f3gy\u00e1szati Oszt\u00e1ly Kistarcsa Semmelweis t\u00e9r 1. 2143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1gnes","family":"Jurcsik","sequence":"additional","affiliation":[{"name":"1 Pest Megyei Fl\u00f3r Ferenc K\u00f3rh\u00e1z B\u0151rgy\u00f3gy\u00e1szati Oszt\u00e1ly Kistarcsa Semmelweis t\u00e9r 1. 2143"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"atypb1","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1176\/ajp.156.7.1019","volume":"156","year":"1999","journal-title":"Am. 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