Carbamazepine
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Reactions 1305 - 12 Jun 2010 S Carbamazepine DRESS syndrome: case report A 34-year-old man developed drug rash with eosinophilia and systemic symptoms (DRESS) syndrome with decreased liver function during treatment with carbamazepine for temporal epilepsy. The man developed epilepsy after a traffic accident in July 2008, and started receiving oral carbamazepine [dosage not stated] and valproic acid. He presented with a 5-day history of general skin eruptions and fever on 22 September 2008. On examination, he had a body temperature of 38.5°C, his face was oedematous and his inguinal lymph nodes were palpable; he had scales around his mouth and petechiae on his soft palate, and erythematous papules were evident over his whole body. Laboratory investigations revealed the following: RBC count 4.35 × 10 6 /mm 3 , WBC count 15 800/mm 3 , CRP 4.22 mg/dL, ALT 415IU, ALP 1138IU , AST 145IU and GGT 1202IU. He had a HHV-7 IgG titre of 80 ×, a CMV IgM titre of 40 × and a CMV IgG titre of 80 ×. Histopathology disclosed mild oedema, and a perivascular lymphocytic infiltrate in the upper dermis; the infiltrate predominantly comprised CD8+ cells. Treatment with carbamazepine was discontinued, and phenobarbital was initiated. The man underwent transfusion therapy, and his skin eruption and liver function improved. However, his skin eruption again worsened 1 month later, and then spontaneously resolved. His HHV-6, HHV-7 and CMV antibody titres had not significantly changed. After complete resolution of DRESS syndrome, a patch test showed a positive reaction to carbamazepine; HHV-6, HHV-7 and CMV were not reactivated. Inadomi T. Drug rash with eosinophilia and systemic symptoms (DRESS): Changing carbamazepine to phenobarbital controlled epilepsy without the recurrence of DRESS. European Journal of Dermatology 20: 220-222, No. 2, Mar- Apr 2010. Available from: URL: http://dx.doi.org/10.1684/ejd.2010.0887 - Japan 803019332 1 Reactions 12 Jun 2010 No. 1305 0114-9954/10/1305-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
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Transcript of Carbamazepine
Reactions 1305 - 12 Jun 2010
SCarbamazepine
DRESS syndrome: case reportA 34-year-old man developed drug rash with
eosinophilia and systemic symptoms (DRESS) syndromewith decreased liver function during treatment withcarbamazepine for temporal epilepsy.
The man developed epilepsy after a traffic accident inJuly 2008, and started receiving oral carbamazepine[dosage not stated] and valproic acid. He presented with a5-day history of general skin eruptions and fever on22 September 2008. On examination, he had a bodytemperature of 38.5°C, his face was oedematous and hisinguinal lymph nodes were palpable; he had scales aroundhis mouth and petechiae on his soft palate, anderythematous papules were evident over his whole body.Laboratory investigations revealed the following: RBCcount 4.35 × 106/mm3, WBC count 15 800/mm3, CRP4.22 mg/dL, ALT 415IU, ALP 1138IU , AST 145IU and GGT1202IU. He had a HHV-7 IgG titre of 80 ×, a CMV IgM titreof 40 × and a CMV IgG titre of 80 ×. Histopathologydisclosed mild oedema, and a perivascular lymphocyticinfiltrate in the upper dermis; the infiltrate predominantlycomprised CD8+ cells.
Treatment with carbamazepine was discontinued, andphenobarbital was initiated. The man underwenttransfusion therapy, and his skin eruption and liver functionimproved. However, his skin eruption again worsened1 month later, and then spontaneously resolved. HisHHV-6, HHV-7 and CMV antibody titres had notsignificantly changed. After complete resolution of DRESSsyndrome, a patch test showed a positive reaction tocarbamazepine; HHV-6, HHV-7 and CMV were notreactivated.Inadomi T. Drug rash with eosinophilia and systemic symptoms (DRESS):Changing carbamazepine to phenobarbital controlled epilepsy without therecurrence of DRESS. European Journal of Dermatology 20: 220-222, No. 2, Mar-Apr 2010. Available from: URL: http://dx.doi.org/10.1684/ejd.2010.0887 -Japan 803019332
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Reactions 12 Jun 2010 No. 13050114-9954/10/1305-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
