Delayed hypersensitivity to antiepileptic drugs in children

Abstract

Background: Antiepileptic drugs (AEDs) are widely used for the treatment of epilepsy, but they can be associated with the development of mainly delayed/non-immediate hypersensitivity reactions (HRs). Although these reactions are usually cutaneous, self-limited and spontaneously resolve within days after drug discontinuation, sometime HRs reactions to AEDs can be severe and life threatening. Aim: This paper seeks to show examples on practical management of AEDs HRs in children starting from a review of what it is already known in literature. Results: Risk factors include age, history of previous AEDs reactions, viral infections, concomitant medications and genetic factors. The diagnosis work-up consists of in vivo (Intradermal testing and Patch testing) and in vitro tests [serological investigation to exclude the role of viral infection,

Ethosuximide‐induced Stevens‐Johnson syndrome/toxic epidermal necrolysis overlap confirmed by patch testing in a child

“…Anticonvulsants, used widely to treat epilepsy in children, may cause nonimmediate T‐cell–mediated life‐threatening cutaneous adverse reactions as Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) 1,2 . Aromatic anticonvulsants are among the most frequent culprits in pediatric SJS/TEN 1,2 .…”

“…Anticonvulsants, used widely to treat epilepsy in children, may cause nonimmediate T‐cell–mediated life‐threatening cutaneous adverse reactions as Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) 1,2 . Aromatic anticonvulsants are among the most frequent culprits in pediatric SJS/TEN 1,2 . Ethosuximide, a nonaromatic antiepileptic, has been rarely implicated in SJS/TEN, with only six cases of SJS and two cases of TEN reported, exclusively in children, as its main indication are absence seizures 1‐4 …”

“…Aromatic anticonvulsants are among the most frequent culprits in pediatric SJS/TEN 1,2 . Ethosuximide, a nonaromatic antiepileptic, has been rarely implicated in SJS/TEN, with only six cases of SJS and two cases of TEN reported, exclusively in children, as its main indication are absence seizures 1‐4 …”

Comments on vitamin D in asthma, milk allergy diagnosis, and stem cell transplantation in chronic granulomatous disease

“…The one published in this issue on delayed hypersensitivity to antiepileptic drugs in children deserves your full attention. 3 It is a tradition that the editorial highlights three articles, and the first one selected is a trial on the efficacy of vitamin D supplementation in asthmatic children. The study was performed in India, a country with increasing numbers of allergic children, but also increasing research in this field.…”

“…As one of the official Journals of EAACI, PAI is always delighted to publish position papers developed by EAACI Committees. The one published in this issue on delayed hypersensitivity to antiepileptic drugs in children deserves your full attention 3 …”