Carbamazepine
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Reactions 1413 - 4 Aug 2012 S Carbamazepine DRESS syndrome: case report A 23-year-old man developed DRESS syndrome while receiving carbamazepine [Tegretol]. The man, who had a 4-year history of marijuana [cannabis] use, was admitted to hospital because of fever and jaundice. He had been receiving carbamazepine 200mg, one tablet three times daily, for 5 weeks for the treatment of his drug addiction. His fever started suddenly 1 week before his admission. Two days later, he developed diffuse erythematous pruritic skin lesions, which initially involved his limbs and then spread to his trunk. He also had polyadenopathy and asthenia. Five days later, he developed jaundice. On admission, he had a fever (40°C), a diffuse macular eruption, polyadenopathy involving his cervical, axillary and inguinal lymph nodes, abdominal tenderness and a pleural effusion on the right side. A complete blood count revealed eosinophilia, and liver function tests showed signs of cholestasis and hepatic cytolysis with 29 fold normal values. He was diagnosed with DRESS syndrome induced by carbamazepine. All his medications were discontinued. The man received prednisone, and his fever resolved within 48 hours. His skin lesions and lymphadenopathies resolved within 6 days. His complete blood count showed normal values within 1 week, and his transaminase levels normalised within 1 month. Author comment: This is a case of hypersensitivity syndrome (DRESS) due to carbamazepine. DRESS syndrome was considered because of the onset, 5 weeks after starting carbamazepine, the skin rash, the eosinophilia and the systemic symptoms, particularly those involving the liver. Traore Y, et al. What is your diagnosis? Flamboyant exanthema in a drug addict in withdrawal. Nouvelles Dermatologiques 31: 161-163, No. 4, Apr 2012 [French; summarised from a translation] - Morocco 803074408 1 Reactions 4 Aug 2012 No. 1413 0114-9954/10/1413-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 1413 - 4 Aug 2012
SCarbamazepine
DRESS syndrome: case reportA 23-year-old man developed DRESS syndrome while
receiving carbamazepine [Tegretol].The man, who had a 4-year history of marijuana
[cannabis] use, was admitted to hospital because of feverand jaundice. He had been receiving carbamazepine200mg, one tablet three times daily, for 5 weeks for thetreatment of his drug addiction. His fever started suddenly1 week before his admission. Two days later, he developeddiffuse erythematous pruritic skin lesions, which initiallyinvolved his limbs and then spread to his trunk. He also hadpolyadenopathy and asthenia. Five days later, he developedjaundice. On admission, he had a fever (40°C), a diffusemacular eruption, polyadenopathy involving his cervical,axillary and inguinal lymph nodes, abdominal tendernessand a pleural effusion on the right side. A complete bloodcount revealed eosinophilia, and liver function testsshowed signs of cholestasis and hepatic cytolysis with29 fold normal values. He was diagnosed with DRESSsyndrome induced by carbamazepine.
All his medications were discontinued. The man receivedprednisone, and his fever resolved within 48 hours. Hisskin lesions and lymphadenopathies resolved within6 days. His complete blood count showed normal valueswithin 1 week, and his transaminase levels normalisedwithin 1 month.
Author comment: This is a case of hypersensitivitysyndrome (DRESS) due to carbamazepine. DRESS syndromewas considered because of the onset, 5 weeks after startingcarbamazepine, the skin rash, the eosinophilia and thesystemic symptoms, particularly those involving the liver.Traore Y, et al. What is your diagnosis? Flamboyant exanthema in a drug addict inwithdrawal. Nouvelles Dermatologiques 31: 161-163, No. 4, Apr 2012 [French;summarised from a translation] - Morocco 803074408
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Reactions 4 Aug 2012 No. 14130114-9954/10/1413-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
