Oxcarbazepine
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Reactions 1329 - 27 Nov 2010 S Oxcarbazepine DRESS syndrome: case report A 45-year-old woman developed drug rash with eosinophilia and systemic symptoms (DRESS) syndrome during oxcarbazepine treatment for a partial epileptic seizure. The woman initiated oxcarbazepine [route and dosage not stated] for a partial epileptic seizure. About 3 weeks later, she developed an urticaria-like eruption. Prednisone and levocetirizine treatment was initiated, but within 48 hours, she was hospitalised with fever, diarrhoea, vomiting and progressive skin lesions. Physical examination also showed hypotension, a HR of 134 beats/min, bilateral crepitations, an oxygen saturation of 90% and maculopapular erythroderma with diffuse purpuric lesions. Infusions of ceftriaxone and macromolecules [Gelofusine] were initiated for suspected purpura fulminans. The woman became agitated and anxious, and her respiratory condition worsened despite oxygen therapy; endotracheal intubation and mechanical ventilation were required. Her haemodynamic status remained unstable. An infusion of norepinephrine [noradrenaline] was initiated. Chest x-ray showed bilateral alveolar injury and electrocardiogram indicated dry pericarditis. Antibacterials, hydrocortisone and fludrocortisone were initiated. As septic shock with respiratory and cardiovascular failure was suspected, drotrecogin-α was started. Her clinical condition stabilised after 24 hours. Skin biopsy analysis indicated lymphocytic and eosinophilic infiltration of her dermis with marked epidermal keratinocyte necrosis. A diagnosis of DRESS syndrome was made. Antibacterials and drotrecogin-α were withdrawn and hydrocortisone was continued. Her condition improved and she was subsequently transferred. There was no recurrence of symptoms. Chakarian J-C, et al. Oxcarbazepine Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome mimicking septic shock. Presse Medicale 39: 1103-1105, Oct 2010. Available from: URL: http://dx.doi.org/10.1016/ j.lpm.2010.04.014 [French; summarised from a translation] - France 803043948 1 Reactions 27 Nov 2010 No. 1329 0114-9954/10/1329-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Oxcarbazepine
Reactions 1329 - 27 Nov 2010
SOxcarbazepine
DRESS syndrome: case reportA 45-year-old woman developed drug rash with
eosinophilia and systemic symptoms (DRESS) syndromeduring oxcarbazepine treatment for a partial epilepticseizure.
The woman initiated oxcarbazepine [route and dosagenot stated] for a partial epileptic seizure. About 3 weekslater, she developed an urticaria-like eruption. Prednisoneand levocetirizine treatment was initiated, but within48 hours, she was hospitalised with fever, diarrhoea,vomiting and progressive skin lesions. Physicalexamination also showed hypotension, a HR of134 beats/min, bilateral crepitations, an oxygen saturationof 90% and maculopapular erythroderma with diffusepurpuric lesions.
Infusions of ceftriaxone and macromolecules[Gelofusine] were initiated for suspected purpurafulminans. The woman became agitated and anxious, andher respiratory condition worsened despite oxygentherapy; endotracheal intubation and mechanicalventilation were required. Her haemodynamic statusremained unstable. An infusion of norepinephrine[noradrenaline] was initiated. Chest x-ray showed bilateralalveolar injury and electrocardiogram indicated drypericarditis. Antibacterials, hydrocortisone andfludrocortisone were initiated. As septic shock withrespiratory and cardiovascular failure was suspected,drotrecogin-α was started. Her clinical condition stabilisedafter 24 hours. Skin biopsy analysis indicated lymphocyticand eosinophilic infiltration of her dermis with markedepidermal keratinocyte necrosis. A diagnosis of DRESSsyndrome was made. Antibacterials and drotrecogin-αwere withdrawn and hydrocortisone was continued. Hercondition improved and she was subsequently transferred.There was no recurrence of symptoms.Chakarian J-C, et al. Oxcarbazepine Drug Rash with Eosinophilia and SystemicSymptoms (DRESS) syndrome mimicking septic shock. Presse Medicale 39:1103-1105, Oct 2010. Available from: URL: http://dx.doi.org/10.1016/j.lpm.2010.04.014 [French; summarised from a translation] - France 803043948
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Reactions 27 Nov 2010 No. 13290114-9954/10/1329-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
