Carbamazepine
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Reactions 1255 - 6 Jun 2009 S Carbamazepine Toxic epidermal necrolysis in a child: case report A 5-year-old boy developed toxic epidermal necrolysis (TEN) during treatment with carbamazepine for epilepsy. The boy started receiving carbamazepine 100 mg/day, with weekly dosage increases of 100mg. He was hospitalised with fever, malaise and an erythematous rash 3 weeks after treatment initiation; his symptoms had developed 1 day after the last dosage increase. Carbamazepine was immediately withdrawn, and the boy received antihistamines and methylprednisolone. However, his rash and bullae continued to progress over the course of the day. The rash covered 60% of his body surface 24 hours after onset, and had spread from his face and neck to his chest, back, upper extremities, and ocular, oral and anal mucosae; Nikolsky sign was positive. He was transferred to an ICU. TEN was diagnosed and his therapy was changed to immune globulin. He also received aggressive fluid replacement therapy, and enteral and parenteral nutrition. His wounds were debrided under general anaesthesia, and covered with chlorhexidine- impregnated paraffin dressings. He also received tobramycin eye ointment and artificial tears. He developed fever of 39°C and neutropenia on hospital day 4, and blood cultures grew E. coli. Sepsis was treated with antibacterials and granulocyte colony stimulating factor. His condition improved, and no further lesions were noted from hospital day 10. Over the following 13 days, extensive re- epithelialisation was observed, and he was discharged on day 37; at that time, all wounds had epithelialised. Sevketoglu E, et al. Toxic epidermal necrolysis in a child after carbamazepine dosage increment. Pediatric Emergency Care 25: 93-95, No. 2, Feb 2009 - Turkey 801141870 1 Reactions 6 Jun 2009 No. 1255 0114-9954/10/1255-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Carbamazepine
Reactions 1255 - 6 Jun 2009
SCarbamazepine
Toxic epidermal necrolysis in a child: case reportA 5-year-old boy developed toxic epidermal necrolysis
(TEN) during treatment with carbamazepine for epilepsy.The boy started receiving carbamazepine 100 mg/day,
with weekly dosage increases of 100mg. He washospitalised with fever, malaise and an erythematous rash3 weeks after treatment initiation; his symptoms haddeveloped 1 day after the last dosage increase.
Carbamazepine was immediately withdrawn, and theboy received antihistamines and methylprednisolone.However, his rash and bullae continued to progress overthe course of the day. The rash covered 60% of his bodysurface 24 hours after onset, and had spread from his faceand neck to his chest, back, upper extremities, and ocular,oral and anal mucosae; Nikolsky sign was positive. He wastransferred to an ICU. TEN was diagnosed and his therapywas changed to immune globulin. He also receivedaggressive fluid replacement therapy, and enteral andparenteral nutrition. His wounds were debrided undergeneral anaesthesia, and covered with chlorhexidine-impregnated paraffin dressings. He also receivedtobramycin eye ointment and artificial tears. He developedfever of 39°C and neutropenia on hospital day 4, and bloodcultures grew E. coli. Sepsis was treated with antibacterialsand granulocyte colony stimulating factor. His conditionimproved, and no further lesions were noted from hospitalday 10. Over the following 13 days, extensive re-epithelialisation was observed, and he was discharged onday 37; at that time, all wounds had epithelialised.Sevketoglu E, et al. Toxic epidermal necrolysis in a child after carbamazepinedosage increment. Pediatric Emergency Care 25: 93-95, No. 2, Feb 2009 -Turkey 801141870
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Reactions 6 Jun 2009 No. 12550114-9954/10/1255-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
