Carbamazepine
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Reactions 1279 - 21 Nov 2009 S Carbamazepine Toxic epidermal necrolysis in a child: case report A 9-year-old boy with febrile seizures developed toxic epidermal necrolysis (TEN) during treatment with carbamazepine. The boy’s therapy was changed from phenobarbital to carbamazepine 150mg three times daily, and he was hospitalised with a 6-day history of fever of up to 106°F, vomiting and a new-onset rash 22 days later. On presentation, a tender, pruritic, erythematous and vesicular rash was evident on his back, neck, face, trunk, abdomen, upper arms and proximal thighs; other symptoms included erythema of his palms and soles, conjunctival injection and mucosal involvement. The rash involved 35% of his total body surface area. On admission to a burn unit, he had a BP of 124/93mm Hg, a pulse rate of 100 beats/min, a respiratory rate of 16 breaths/min and a body temperature of 97.9°F. A skin biopsy revealed epidermal necrosis with re-epithelialisation and a sparse superficial dermal perivascular lymphocytic infiltrate. Immunofluorescence was positive for IgG, IgM, IgA, C3 and fibrin within the necrotic epidermal material. The boy underwent blister debridement, and his skin was covered with a pig skin xenograft. He received wound care and immune globulin. His lesions did not progress, and he was discharged after 24 hours; at that time, his skin had fully re-epithelialised. He made a complete recovery without sequelae. Author comment: "We present a pediatric patient who developed TEN after treatment with carbamazepine." Gandhi M, et al. Blister fluid composition in a pediatric patient with toxic epidermal necrolysis. Journal of Burn Care and Research 29: 671-675, No. 4, Jul- Aug 2008 - USA 801154733 1 Reactions 21 Nov 2009 No. 1279 0114-9954/10/1279-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Carbamazepine
Reactions 1279 - 21 Nov 2009
SCarbamazepine
Toxic epidermal necrolysis in a child: case reportA 9-year-old boy with febrile seizures developed toxic
epidermal necrolysis (TEN) during treatment withcarbamazepine.
The boy’s therapy was changed from phenobarbital tocarbamazepine 150mg three times daily, and he washospitalised with a 6-day history of fever of up to 106°F,vomiting and a new-onset rash 22 days later. Onpresentation, a tender, pruritic, erythematous and vesicularrash was evident on his back, neck, face, trunk, abdomen,upper arms and proximal thighs; other symptoms includederythema of his palms and soles, conjunctival injection andmucosal involvement. The rash involved 35% of his totalbody surface area. On admission to a burn unit, he had a BPof 124/93mm Hg, a pulse rate of 100 beats/min, arespiratory rate of 16 breaths/min and a body temperatureof 97.9°F. A skin biopsy revealed epidermal necrosis withre-epithelialisation and a sparse superficial dermalperivascular lymphocytic infiltrate. Immunofluorescencewas positive for IgG, IgM, IgA, C3 and fibrin within thenecrotic epidermal material.
The boy underwent blister debridement, and his skinwas covered with a pig skin xenograft. He received woundcare and immune globulin. His lesions did not progress,and he was discharged after 24 hours; at that time, his skinhad fully re-epithelialised. He made a complete recoverywithout sequelae.
Author comment: "We present a pediatric patient whodeveloped TEN after treatment with carbamazepine."Gandhi M, et al. Blister fluid composition in a pediatric patient with toxicepidermal necrolysis. Journal of Burn Care and Research 29: 671-675, No. 4, Jul-Aug 2008 - USA 801154733
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Reactions 21 Nov 2009 No. 12790114-9954/10/1279-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
