Carbamazepine
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Reactions 1434 - 12 Jan 2013 S Carbamazepine Toxic epidermal necrolysis and rhabdomyolysis: case report A 30-year-old man developed toxic epidermal necrolysis (TEN) and rhabdomyolysis while receiving carbamazepine; he subsequently died. The man, who had a schizophrenic disorder, started carbamazepine 200mg twice daily for mood stabilisation [route not stated]. Within 4 days, he developed anorexia, malaise, conjunctivitis and a generalised pruritic skin rash. Carbamazepine was withdrawn, and the man was admitted to an ICU. Examination revealed papules, blisters and ulcerations. Over 24 hours after admission, he developed skin erosions and bullae over his upper body, whilst his epidermis began detaching over 50% of his body surface area. Nikolsky’s sign was positive. Skin biopsy revealed full thickness necrosis and dermoepidermal detachment consistent with TEN. In addition, he developed severe muscle aches over his gluteal and thigh muscles. Urinalysis revealed a urine myoglobin level of 7421 µg/L, while an ECG revealed sinus tachycardia. Rhabdomyolysis was suspected based on clinical signs and laboratory test results. He received supportive care, fluids and surgical debridement. However, his renal function deteriorated, and he developed hypovolaemic shock and GI bleeding. Four days after admission, he died due to multiple organ failure and acute respiratory distress syndrome. Author comment: "In conclusion, besides a common visceral involvement, rhabdomyolysis should also be considered another possible complication of carbamazepine- induced TEN." Huang L-Y, et al. Rhabdomyolysis as a potential complication of carbamazepine- induced toxic epidermal necrolysis. Clinical Biochemistry 45: 1531-1532, No. 16-17, Nov 2012. Available from: URL: http://dx.doi.org/10.1016/ j.clinbiochem.2012.06.008 - Taiwan 803081974 1 Reactions 12 Jan 2013 No. 1434 0114-9954/10/1434-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 1434 - 12 Jan 2013
SCarbamazepine
Toxic epidermal necrolysis and rhabdomyolysis:case report
A 30-year-old man developed toxic epidermal necrolysis(TEN) and rhabdomyolysis while receiving carbamazepine; hesubsequently died.
The man, who had a schizophrenic disorder, startedcarbamazepine 200mg twice daily for mood stabilisation[route not stated]. Within 4 days, he developed anorexia,malaise, conjunctivitis and a generalised pruritic skin rash.
Carbamazepine was withdrawn, and the man was admittedto an ICU. Examination revealed papules, blisters andulcerations. Over 24 hours after admission, he developed skinerosions and bullae over his upper body, whilst his epidermisbegan detaching over 50% of his body surface area. Nikolsky’ssign was positive. Skin biopsy revealed full thickness necrosisand dermoepidermal detachment consistent with TEN. Inaddition, he developed severe muscle aches over his glutealand thigh muscles. Urinalysis revealed a urine myoglobin levelof 7421 µg/L, while an ECG revealed sinus tachycardia.Rhabdomyolysis was suspected based on clinical signs andlaboratory test results. He received supportive care, fluids andsurgical debridement. However, his renal functiondeteriorated, and he developed hypovolaemic shock and GIbleeding. Four days after admission, he died due to multipleorgan failure and acute respiratory distress syndrome.
Author comment: "In conclusion, besides a commonvisceral involvement, rhabdomyolysis should also beconsidered another possible complication of carbamazepine-induced TEN."Huang L-Y, et al. Rhabdomyolysis as a potential complication of carbamazepine-induced toxic epidermal necrolysis. Clinical Biochemistry 45: 1531-1532, No.16-17, Nov 2012. Available from: URL: http://dx.doi.org/10.1016/j.clinbiochem.2012.06.008 - Taiwan 803081974
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Reactions 12 Jan 2013 No. 14340114-9954/10/1434-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
