Carbamazepine
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Reactions 502 - 21 May 1994 S Carbamazepine Multisystem disorders due to hypersensitivity: case report Multisystem disorders caused by drug hypersensitivity occurred in a 15-year-old boy who was taking carbamazepine therapy for epilepsy. Two weeks after commencing carbamazepine 200mg tid, the patient developed fever, headache, eyelid oedema, jaundice, hepatomegaly, splenomegaly, cervical and occipital lymphadenopathy, petechial enanthema, hypertrophic tonsils and a morbilliform exanthema. Tests revealed raised levels of lymphocytes, eosinophils and basophils. Total and direct bilirubin were markedly raised, as were the transaminases. The rheumatoid factor and antinuclear antibodies were negative. Carbamazepine therapy was stopped, and prednisone 1 mg/kg/day was commenced. Within 1 week the patient’s temperature returned to normal, and by the second week all the symptoms had disappeared. Author comment: ‘Drug hypersensitivity should be considered in any patient on CBZ [carbamazepine] who presents with symptoms and signs suggesting either a lymphoma or a viral illness. Drug withdrawal could be used in diagnosis, as well as an appropriate and effective therapeutic measure. The decision to withdraw CBZ was made for two reasons: the reaction’s early onset and the degree of severity.’ Merino N, et al. Multisystem hypersensitivity reaction to carbamazepine. Annals of Pharmacotherapy 28: 402-403, Mar 1994 - Spain 800260957 1 Reactions 21 May 1994 No. 502 0114-9954/10/0502-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
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Transcript of Carbamazepine
Reactions 502 - 21 May 1994
SCarbamazepine
Multisystem disorders due to hypersensitivity: casereport
Multisystem disorders caused by drug hypersensitivityoccurred in a 15-year-old boy who was taking carbamazepinetherapy for epilepsy.
Two weeks after commencing carbamazepine 200mg tid,the patient developed fever, headache, eyelid oedema,jaundice, hepatomegaly, splenomegaly, cervical and occipitallymphadenopathy, petechial enanthema, hypertrophic tonsilsand a morbilliform exanthema.
Tests revealed raised levels of lymphocytes, eosinophils andbasophils. Total and direct bilirubin were markedly raised, aswere the transaminases. The rheumatoid factor andantinuclear antibodies were negative.
Carbamazepine therapy was stopped, and prednisone 1mg/kg/day was commenced. Within 1 week the patient’stemperature returned to normal, and by the second week allthe symptoms had disappeared.
Author comment: ‘Drug hypersensitivity should beconsidered in any patient on CBZ [carbamazepine] whopresents with symptoms and signs suggesting either alymphoma or a viral illness. Drug withdrawal could be used indiagnosis, as well as an appropriate and effective therapeuticmeasure. The decision to withdraw CBZ was made for tworeasons: the reaction’s early onset and the degree of severity.’Merino N, et al. Multisystem hypersensitivity reaction to carbamazepine. Annals ofPharmacotherapy 28: 402-403, Mar 1994 - Spain 800260957
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Reactions 21 May 1994 No. 5020114-9954/10/0502-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
