Reactions 1183 - 5 Jan 2008

SCarbamazepine

DRESS syndrome in a child: case reportA 10-year-old girl developed drug rash with eosinophilia and

systemic symptoms (DRESS) syndrome during treatment withcarbamazepine for complex partial seizures.

The girl started receiving carbamazepine and, over 4 weeks,her dosage was gradually increased to 2 x 600mg [initialdosage and frequency of administration not stated].Subsequently, she was noted to become progressivelysomnolent; she developed fever of up to 39.5°C and presentedto a hospital the following day [duration of treatment toreaction onset not stated]. On presentation, her generalcondition was reduced, she had a maculopapular exanthema,and her cervical and inguinal lymph nodes were enlarged.Laboratory investigations revealed the following levels: AST538 U/L, ALT 789 U/L, γ-glutamyl transferase 655 U/L,glutamate dehydrogenase 156/L, ALP 359 U/L, lactatedehydrogenase 1211 U/L, total bilirubin 0.6 mg/dL, ammonia53 µmol/L, amylase 23 U/L and lipase 15 U/L. She had a WBCcount of 5.5 G/L with 19% eosinophils, and her carbamazepineconcentration was 47 µmol/L; human herpes virus-6 IgG waspositive and IgM was borderline. An abdominal ultrasoundshowed a slightly enlarged liver and markedly enlarged spleen(174mL volume).

The girl was admitted and carbamazepine was discontinued.Her clinical condition progressively improved and her livervalues slowly normalised. Her treatment was changed tolevetiracetam 3 weeks after carbamazepine discontinuation.Wurpts G, et al. DRESS syndrome caused by carbamazepine. Hautarzt 58:935-936, No. 11, Nov 2007 [German] - Germany 801096081

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Reactions 5 Jan 2008 No. 11830114-9954/10/1183-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved