Anticonvulsant hypersensitivity syndrome: clinic case and literature review

Authors

  • Sebastian Leonangeli Laboratorio de Neurofisiología, IMMF-INIMEC-CONICET-UNC
  • Jazmín Azul Fraire Cátedra de Farmacología General, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba
  • Jorge Luis Loza Policlínico Policial, Córdoba, Argentina

DOI:

https://doi.org/10.31053/1853.0605.v77.n3.27857

Keywords:

anticonvulsants, drug hypersensitivity, leucopenia

Abstract

Introduction: The anticonvulsant hypersensitivity syndrome is a rare adverse reaction in which the skin, lymph nodes and internal organs are affected. It is usually caused by classic anticonvulsants such as phenytoin, carbamazepine or phenobarbital. Case report: Here we present the case of a 25-year-old woman from Córdoba, Argentina, who suffered a severe reaction to oxcarbazepine with a rash, lymphadenopathy, hepatitis and an unusual analytic. Clinical abnormalities were reversed after oxcarbazepine was terminated and treatment with diphenhydramine and dexamethasone was initiated. Discussion: DRESS syndrome is a hypersensitivity reaction that takes weeks to manifest, and is characterized by rash, leukocytosis with eosinophilia, adenopathies, liver involvement, and reactivation of the herpes virus 6, being more frequent in carbamazepine or phenytoin, and in rare cases to oxcarbazepine. Conclusions: In general, this strong medicine is not taken into account as a cause of hypersensitivity, reports suggest that it could be related to cases similar to this one, and studies that are more targeted are required, due to the morbidity and mortality of the syndrome.

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Author Biographies

  • Sebastian Leonangeli, Laboratorio de Neurofisiología, IMMF-INIMEC-CONICET-UNC

    MD, Psychiatry Resident

  • Jazmín Azul Fraire, Cátedra de Farmacología General, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba

    MD, Resident of Neurosurgery

     

     

  • Jorge Luis Loza, Policlínico Policial, Córdoba, Argentina

    MD, Internal Medicine specialist

References

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2. Moon J, Kim TJ, Lim JA, Sunwoo JS, Byun JI, Lee ST, Jung KH, Park KI, Jung KY, Jeon D, Yu KS, Jang IJ, Chu K, Lee SK. HLA-B*40:02 and DRB1*04:03 are risk factors for oxcarbazepine-induced maculopapular eruption. Epilepsia. 2016 Nov;57(11):1879-1886. doi: 10.1111/epi.13566.

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6. Handoko KB, van Puijenbroek EP, Bijl AH, Hermens WA, Zwart-van Rijkom JE, Hekster YA, Egberts TC. Influence of chemical structure on hypersensitivity reactions induced by antiepileptic drugs: the role of the aromatic ring. Drug Saf. 2008;31(8):695-702. doi: 10.2165/00002018-200831080-00006.

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8. Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. The diagnosis of a DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations. Br J Dermatol. 2007 May;156(5):1083-4. doi: 10.1111/j.1365-2133.2007.07807.x.

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11. Hsu HF, Huang SY. Severe hepatitis associated with administration of oxcarbazepine. Pediatr Int. 2010 Aug;52(4):677-8. doi: 10.1111/j.1442-200X.2010.03154.x.

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Published

2020-08-21

Issue

Section

Case Report

How to Cite

1.
Anticonvulsant hypersensitivity syndrome: clinic case and literature review. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 2020 Aug. 21 [cited 2024 Oct. 24];77(3):211-3. Available from: https://revistas.psi.unc.edu.ar/index.php/med/article/view/27857

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