Reactions 1420 - 22 Sep 2012

SCarbamazepine

DRESS syndrome: 2 case reportsTwo patients, a man and his mother, developed DRESS

syndrome while receiving carbamazepine [dosages androutes not stated]. Elispot assay was positive in both cases,suggesting familial sensitivity to the drug.

A 23-year-old man receiving carbamazepine for epilepsypresented with pyrexia, headaches and hepaticdysfunction. He also had a 3-week history of generalisedmaculopapular exanthema with urticated features,consistent with eosinophilia. He had startedcarbamazepine 5 weeks before the onset of rash.Histological findings were consistent with DRESSsyndrome. Carbamazepine was discontinued and hereceived a short course of oral steroids and his systemicand cutaneous symptoms resolved a few weeks later.

The man’s mother [age not stated] presented 3 monthslater, with fever, headaches, eosinophilia, abnormal liverfunction, and a 1-week history of rash. She was alsoexperiencing aphthous ulcers affecting her oral mucosa.She had been receiving carbamazepine for trigeminalneuralgia; she had started the drug 10 weeks before theonset of rash. DRESS syndrome was diagnosed, andcarbamazepine was discontinued. She received topicalsteroids; her rash improved, but systemic and cutaneoussymptoms took longer to resolve.

Author comment: "We report a familial case of drugreaction with eosinophilia and systemic symptoms (DRESS) tocarbamazepine."Anjum N, et al. Familial occurrence of drug reaction with eosinophilia andsystemic symptoms to carbamazepine. British Journal of Dermatology 167: 53abstr. P70, Jul 2012. Available from: URL: http://dx.doi.org/10.1111/j.1365-2133.2012.10938.x - United Kingdom 803077378

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Reactions 22 Sep 2012 No. 14200114-9954/10/1420-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved