Carbamazepine induced anticonvulsant hypersensitivity syndrome

Shivamurthy, Shwetha; Ravishankar, M.

doi:10.18203/2319-2003.ijbcp20150891

Cited by 3 publications

(8 citation statements)

References 13 publications

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“…Commonly, fever and malaise are the first manifestations [ 4 ]. Skin rash is seen in 90% of the AHS cases, which is mainly a maculopapular eruption with subsequent desquamation during resolution [ 1 ]. Moreover, the rash can be ranged from morbilliform eruption to more severe forms like Steven Johnson syndrome or toxic epidermal necrosis [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hepatic involvement could be just an elevation of the liver enzymes level up to fulminant hepatic failure [ 20 ]. Hematological manifestation as leukocytosis with atypical lymphocytes and increased eosinophil are seen in 50% of patients [ 1 ]. Other possible abnormalities like carditis, pneumonitis, conjunctivitis, thrombocytopenia, splenomegaly, myalgia and hemolytic anemia can be seen as well [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…The syndrome has been reported with aromatic antiepileptic drugs (AEDS); such as phenytoin, carbamazepine and phenobarbital [1]. AHS is a triad of fever, rash, and internal organ involvement.…”

Section: Introductionmentioning

confidence: 99%

“…Anticonvulsant hypersensitivity syndrome (AHS) is a rare, potentially fatal, systemic and idiosyncratic drug-induced reaction. The syndrome has been reported with aromatic antiepileptic drugs (AEDS); such as phenytoin, carbamazepine and phenobarbital [ 1 ]. AHS is a triad of fever, rash, and internal organ involvement.…”

Section: Introductionmentioning

confidence: 99%

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Anticonvulsant hypersensitivity syndrome after phenytoin administration in an adolescent patient: a case report and review of literature

Ghannam¹,

Mansour²,

Nabulsi³

et al. 2017

Clin Mol Allergy

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BackgroundHypersensitivity is a rare adverse drug reaction (ADR) associated with anti-epileptic medications. Phenytoin is one of the commonly used drugs for treatment of epilepsy that encounters a hypersensitivity reaction. This reaction can be ranged from mild cutaneous rash to anticonvulsant hypersensitivity syndrome (AHS) or drug reaction with eosinophilia and systemic symptoms (DRESS) that includes fever, rash, eosinophilia and involvement of multiple internal organs.Case presentationA 15 year old middle eastern female patient from Gaza strip with free past medical and allergic history. She presented to An-Najah National University Hospital (NNUH) in Nablus with intermittent high grade fever, jaundice, rash and skin peeling. On examination, she had axillary and inguinal lymphadenopathy, moderate splenomegaly and diffuse maculopapular rash. The patient was on phenytoin which started 1 month prior to her presentation as a seizure prophylaxis due to previous head injury. Eventually, the patient was diagnosed with AHS/DRESS.ConclusionsAHS is a diagnosis of exclusion and it is significantly underreported that requires a high index of suspicion. We liked to share this case and shed the light in more details on AHS/DRESS. Our goal was to help making AHS more reported in the literature in adolescent patients, as well as to make physicians more alert of this condition’s seriousness when they prescribe antiepileptic medications in particular. In this report, we included the first case of AHS which was reported in an adolescent patient in Palestine. Moreover, we reviewed the available literature for a better understanding of the pathophysiology and management of AHS. We still believe that the full understanding of the pathogenesis of AHS is lacking, and also we are lacking a clinical tool or scoring system to determine the severity of AHS/DRESS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Anticonvulsant hypersensitivity syndrome after phenytoin administration in an adolescent patient: a case report and review of literature

Ghannam¹,

Mansour²,

Nabulsi³

et al. 2017

Clin Mol Allergy

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“…AHS priklauso retoms nepageidaujamoms vaistų reakcijoms -pasitaiko nuo 1/1000 iki 1/10 000 pacientų [2]. Kadangi AHS metu pažeidžiamos įvairios organų sistemos, ši būklė gali būti letali, todėl reikalauja skubaus įsikišimo, visų pirma, nutraukiant vaistą, sukėlusį AHS [3][4][5].…”

Section: įVadasunclassified

Klinikinis Atvejis: Karbamazepino Sukeltas Antikonvulsantų Hiperjautrumo Sindromas Ir Agranuliocitozė

Kučinskaitė¹,

Dlugauskas²

2019

Public Health

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Aprašytas antikonvulsantų hiperjautrumo sindromas ir agranuliocitozė 40 m. amžiaus moteriai, sergančiai šizoafektiniu sutrikimu (depresinio tipo) ir vartojusiai karbamazepiną. Klinikinė šių net dviejų kartu atsiradusių nepageidaujamų karbamazepino sukeltų reakcijų išraiška buvo febrili neutropenija, viso kūno niežtintis makulopapulinis bėrimas, taip pat padidėjęs kepenų fermentų kiekis. Nutraukus karbamazepiną klinika išnyko, vėl pradėjus vartoti šį vaistą – simptomatika pasikartojo. Visiškai nutraukus karbamazepino vartojimą ir paskyrus tinkamą simptominį gydymą, pacientės būklė pagerėjo, simptomai išnyko. Kraujo tyrimuose normalizavosi leukopenija, agranuliocitozė ir kepenų fermentų kiekis. Nors karbamazepino sukeltos nepageidaujamos reakcijos pasitaiko retai, skiriant šį vaistą klinikinėje praktikoje specialistams svarbu prisiminti šių reakcijų galimybę.

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A Case Report on Well Known but Has to Be Reported Adverse Effect of Phenytoin-Induced Rash and Assessment of Its Severity Based on Adverse Drug Reaction Reporting Scales

Kaur

SINGH

2022

Asian J Pharm Clin Res

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Phenytoin is an aromatic antiepileptic drug, commonly used for the purpose of treating generalized tonic clonic and partial seizures. The drug has been known to cause hypersensitivity reaction, which can be life-threatening by involving internal organs, and is referred as anticonvulsant hypersensitivity syndrome. The treatment in such cases is the immediate discontinuation of the agent causing the reaction and replacing the treatment with other non-aromatic anticonvulsant agent. This case report presents an adverse drug reaction and occurs within 1 week of starting the treatment, a well-known but has to report this adverse effect.

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Carbamazepine induced anticonvulsant hypersensitivity syndrome

Cited by 3 publications

References 13 publications

Anticonvulsant hypersensitivity syndrome after phenytoin administration in an adolescent patient: a case report and review of literature

Anticonvulsant hypersensitivity syndrome after phenytoin administration in an adolescent patient: a case report and review of literature

Klinikinis Atvejis: Karbamazepino Sukeltas Antikonvulsantų Hiperjautrumo Sindromas Ir Agranuliocitozė

A Case Report on Well Known but Has to Be Reported Adverse Effect of Phenytoin-Induced Rash and Assessment of Its Severity Based on Adverse Drug Reaction Reporting Scales

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