Carbamazepine
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Reactions 1232 - 13 Dec 2008 S Carbamazepine Drug-induced hypersensitivity syndrome: case report A 14-year-old boy developed drug-induced hypersensitivity syndrome during treatment with oral carbamazepine for localisation-related epilepsy. The boy, who had been receiving oral carbamazepine 200 mg/day for 16 days, was hospitalised with low-grade fever (37.8°C), fatigue, pruritus and erythema; 3 days before hospitalisation, he had developed intermittent abdominal discomfort and low-grade fever. He had erythema on his cheeks and macules measuring 1–2mm diameter were scattered on his arms and upper part of the trunk. Laboratory investigations revealed the following levels: C-reactive protein 1.38 mg/dL, AST 403 IU/L, ALT 549 IU/L and LDH 637 IU/L; his peripheral WBC count was 6100/µL with 13% atypical lymphocytes. On hospital day 1, carbamazepine was discontinued and, on day 6, the boy started receiving a systemic corticosteroid. However, his fever persisted and the macules spread to cover his entire body surface; he had erythroderma with oedematous changes involving his entire body. He developed papules with crusts and scales around his lips and bilateral enlargement of multiple cervical, axial and inguinal lymph nodes. His WBC count increased to 34 500/µL with 23.5% eosinophils and 19.5% atypical lymphocytes. On day 11, his symptoms gradually started improving. However, on day 15, high fever, abdominal discomfort and erythema with purpura had again worsened. Laboratory investigations revealed marked liver dysfunction with AST and ALT levels of 1170 IU/L and 700 IU/L, respectively. On day 19, human herpesvirus 6 (HHV-6) genome with 32 000 copies/µg DNA was detected in his blood; HHV-6 was isolated from his peripheral blood mononuclear cells. On day 26, his anti- HHV-6 IgG titer had increased. He was diagnosed with drug- induced hypersensitivity syndrome. After a few days, his symptoms gradually subsided without any sequelae. Suzuki Y, et al. Carbamazepine-induced drug-induced hypersensitivity syndrome in a 14-year-old Japanese boy. Epilepsia 49: 2118-2121, No. 12, Dec 2008 - Japan 801124951 1 Reactions 13 Dec 2008 No. 1232 0114-9954/10/1232-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 1232 - 13 Dec 2008
SCarbamazepine
Drug-induced hypersensitivity syndrome: casereport
A 14-year-old boy developed drug-induced hypersensitivitysyndrome during treatment with oral carbamazepine forlocalisation-related epilepsy.
The boy, who had been receiving oral carbamazepine200 mg/day for 16 days, was hospitalised with low-grade fever(37.8°C), fatigue, pruritus and erythema; 3 days beforehospitalisation, he had developed intermittent abdominaldiscomfort and low-grade fever. He had erythema on hischeeks and macules measuring 1–2mm diameter werescattered on his arms and upper part of the trunk. Laboratoryinvestigations revealed the following levels: C-reactive protein1.38 mg/dL, AST 403 IU/L, ALT 549 IU/L and LDH 637 IU/L; hisperipheral WBC count was 6100/µL with 13% atypicallymphocytes.
On hospital day 1, carbamazepine was discontinued and, onday 6, the boy started receiving a systemic corticosteroid.However, his fever persisted and the macules spread to coverhis entire body surface; he had erythroderma withoedematous changes involving his entire body. He developedpapules with crusts and scales around his lips and bilateralenlargement of multiple cervical, axial and inguinal lymphnodes. His WBC count increased to 34 500/µL with23.5% eosinophils and 19.5% atypical lymphocytes. Onday 11, his symptoms gradually started improving. However,on day 15, high fever, abdominal discomfort and erythemawith purpura had again worsened. Laboratory investigationsrevealed marked liver dysfunction with AST and ALT levels of1170 IU/L and 700 IU/L, respectively. On day 19, humanherpesvirus 6 (HHV-6) genome with 32 000 copies/µg DNAwas detected in his blood; HHV-6 was isolated from hisperipheral blood mononuclear cells. On day 26, his anti-HHV-6 IgG titer had increased. He was diagnosed with drug-induced hypersensitivity syndrome. After a few days, hissymptoms gradually subsided without any sequelae.Suzuki Y, et al. Carbamazepine-induced drug-induced hypersensitivity syndromein a 14-year-old Japanese boy. Epilepsia 49: 2118-2121, No. 12, Dec 2008 -Japan 801124951
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Reactions 13 Dec 2008 No. 12320114-9954/10/1232-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
