Carbamazepine
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Reactions 1492, p15 - 15 Mar 2014 S Carbamazepine Anticonvulsant hypersensitivity syndrome: 3 case reports Three patients developed anticonvulsant hypersensitivity syndrome while receiving carbamazepine. A 30-year-old man was diagnosed with herpes labialis and given treatment including carbamazepine 200mg twice per day [route not stated]. His herpes labialis lesions improved initially. However, after 10 days, he developed lesions in his oral mucosa which ultimately spread to cover his whole body. The man was given steroids, erythromycin and cetirizine, but he worsened after 5 days and was admitted to hospital. Cutaneous and ophthalmic examinations suggested anticonvulsant hypersensitivity syndrome. Blood tests were indicative of liver and kidney involvement, and carbamazepine was withdrawn. He was administered pheniramine maleate, dexamethasone, azithromycin and ranitidine and improved after 5 days, with normalisation of his liver enzymes. A 41-year-old man was diagnosed with herpes zoster and initiated on treatment including tablet carbamazepine 300mg once per day [route not stated]. His herpes zoster lesions abated within 5 days, but on day 7 of treatment new reddish skin lesions appeared on his trunk. The man’s drug treatments were all stopped, and his lesions subsided. However, he returned with shooting pain due to herpes zoster and was restarted on carbamazepine. After 9 days, he again developed reddish lesions over his trunk. These spread to his upper and lower limbs and he was admitted to hospital. Blood tests suggested mild liver involvement, and carbamazepine was stopped. He was treated with pheniramine maleate and dexamethasone, after which his lesions resolved and his liver enzyme values normalised. A 50-year-old man was started on tablet carbamazepine 300mg once per day [route not stated] for trigeminal neuralgia. After 8 days reddish skin lesions occurred all over his body, spreading to the oral cavity; fever was also present. A drug reaction was suspected, and he was admitted to hospital and diagnosed with maculopapular eruptions due to carbamazepine. Blood tests were suggestive of liver and kidney involvement and carbamazepine was immediately discontinued. The man was treated with pheniramine maleate and prednisolone, and made a good clinical improvement. Author comment: "We report three interesting cases of [anticonvulsant hypersensitivity syndrome]-drug hypersensitivity reactions induced by carbamazepine." "Causality assessment with Naranjo scale shows certain association between drug and ADR for case 2 while it shows probable association for case 1 and 3." Mehta M, et al. Anticonvulsant hypersensitivity syndrome associated with carbamazepine administration: Case series. Journal of Pharmacology and Pharmacotherapeutics 5: 60-63, No. 1, 2014 - India 803100420 1 Reactions 15 Mar 2014 No. 1492 0114-9954/14/1492-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
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Transcript of Carbamazepine
Reactions 1492, p15 - 15 Mar 2014
SCarbamazepine
Anticonvulsant hypersensitivity syndrome: 3 casereports
Three patients developed anticonvulsant hypersensitivitysyndrome while receiving carbamazepine.
A 30-year-old man was diagnosed with herpes labialis andgiven treatment including carbamazepine 200mg twice perday [route not stated]. His herpes labialis lesions improvedinitially. However, after 10 days, he developed lesions in hisoral mucosa which ultimately spread to cover his whole body.The man was given steroids, erythromycin and cetirizine, buthe worsened after 5 days and was admitted to hospital.Cutaneous and ophthalmic examinations suggestedanticonvulsant hypersensitivity syndrome. Blood tests wereindicative of liver and kidney involvement, and carbamazepinewas withdrawn. He was administered pheniramine maleate,dexamethasone, azithromycin and ranitidine and improvedafter 5 days, with normalisation of his liver enzymes.
A 41-year-old man was diagnosed with herpes zoster andinitiated on treatment including tablet carbamazepine 300mgonce per day [route not stated]. His herpes zoster lesionsabated within 5 days, but on day 7 of treatment new reddishskin lesions appeared on his trunk. The man’s drug treatmentswere all stopped, and his lesions subsided. However, hereturned with shooting pain due to herpes zoster and wasrestarted on carbamazepine. After 9 days, he again developedreddish lesions over his trunk. These spread to his upper andlower limbs and he was admitted to hospital. Blood testssuggested mild liver involvement, and carbamazepine wasstopped. He was treated with pheniramine maleate anddexamethasone, after which his lesions resolved and his liverenzyme values normalised.
A 50-year-old man was started on tablet carbamazepine300mg once per day [route not stated] for trigeminal neuralgia.After 8 days reddish skin lesions occurred all over his body,spreading to the oral cavity; fever was also present. A drugreaction was suspected, and he was admitted to hospital anddiagnosed with maculopapular eruptions due tocarbamazepine. Blood tests were suggestive of liver andkidney involvement and carbamazepine was immediatelydiscontinued. The man was treated with pheniramine maleateand prednisolone, and made a good clinical improvement.
Author comment: "We report three interesting cases of[anticonvulsant hypersensitivity syndrome]-drughypersensitivity reactions induced by carbamazepine.""Causality assessment with Naranjo scale shows certainassociation between drug and ADR for case 2 while it showsprobable association for case 1 and 3."Mehta M, et al. Anticonvulsant hypersensitivity syndrome associated withcarbamazepine administration: Case series. Journal of Pharmacology andPharmacotherapeutics 5: 60-63, No. 1, 2014 - India 803100420
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Reactions 15 Mar 2014 No. 14920114-9954/14/1492-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
