Hypersensitive syndrome reaction of antiepileptic drug: two case reports and literature review

doi:10.5246/jcps.2015.02.015

Journal of Chinese Pharmaceutical Sciences ›› 2015, Vol. 24 ›› Issue (2): 128-132.DOI: 10.5246/jcps.2015.02.015

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Hypersensitive syndrome reaction of antiepileptic drug: two case reports and literature review

Xiangji Dang¹, Haisheng Jiao^1*, Faqin Wang¹, Fei Yang¹, Hui Li²

1. Lanzhou University Second Hospital, Lanzhou 730030, China
2. Pharmacy College of Lanzhou University, Lanzhou 730000, China

Received:2014-08-25 Revised:2014-10-07 Online:2015-02-01 Published:2014-10-15
Contact: Tel.: 86-931-8942751, Fax: 86-931-8463553

Abstract

Abstract:

Hypersensitivity syndrome reaction of antiepileptic drug (AED) can induce serious cutaneous, hematological and hepaticevents. In severe cases, fulminant hepatic failure may necessitate liver transplantation, and most patients die due to the liver failure. Severe adverse cutaneous reactions, including Steven-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and hypersensitivity syndrome, are rare but life-threatening. Its morality rate is as high as 5%–50%. Accurate early diagnosis and timely treatment may contribute to decreased morality rate. In this paper, we reported cases of hypersensitive syndrome reaction to carbamazepine (CBZ) or phenobarbital (PB) in two patients with epilepsy. Clarification of the therapeutic process and the early manifestation of epilepsy may be helpful to improve the epilepsy therapy while avoiding the potential severe adverse cutaneous reactions of AED. The two reported cases highlighted that the therapeutic process of CBZ and PB might lead to the fatal allergic reaction, which was mainly caused by the absence of epoxide-hydroxylase and the defect of hepatocytes.

Key words: Antiepileptic drug hypersensitive syndrome, Carbamazepine, Phenobarbital, Antiepileptic drug

CLC Number:

R969

Supporting:

Xiangji Dang, Haisheng Jiao, Faqin Wang, Fei Yang, Hui Li. Hypersensitive syndrome reaction of antiepileptic drug: two case reports and literature review[J]. Journal of Chinese Pharmaceutical Sciences, 2015, 24(2): 128-132.

References

[1] Lin, J.J.; Lin, K.L.; Hsia, S.H. Pediatric Neurology. , 47, 448-450.2012

[2] Ettore, B. Epilepsia. 2009, 50, 4-10.

[3] Neuman, M.G.; Shear, N.H.; Malkiewicz, I.M. Exp. Dermatol. 2008, 17, 1045-1051.

[4] Phillips, E.J.; Chung, W.H.; Mockenhaupt, M. J. Allergy Clin. Immunol. 2011, 127, S60-S66.

[5] Neuman, M.G.; Cohen, L.; Nanau, R.M. Transl. Res. , 159, 397-406.2012

[6] Nazıroğlu, M.; Yürekli, V.A. Cell. Mol. Neurobiol. 2013, 33, 589-599.

[7] An, D.M.; Wu, X.T.; Hu, F.Y. Epilepsy Res. 2010, 92, 226-230.

[8] Senna, G.; Bonadonna, P.; Caruso, B. J. Allergy Clin. Immunol. 2011, 127, AB198.

[9] Neuman, M.G.; Shear, N.H.; Malkiewicz, I.M. Exp. Dermatol. 2008, 17, 1045-1051.

[10] De, L.G.; Verdoia, M.; Binda, G. Int. J. Cardiol. 2013, 167, 561-563.

[11] Watanabe, H. The J. Dermatol. 2011, 38, 229-235.

[12] He, N.; Mini, F.L.; Shi, Y.W. Seizure. 2012, 21, 614-618.

[13] Ghislain, P.D.; Roujeau, J.C. Dermatol. Online. , 8, 52002.

[14] Power, W.J.; Ghoraishi, M. Ophthalmology. 1995, 102, 1669-1676.

[15] McGee, T.; Munster, A. Plast Reconstr Surg. 1998, 102, 1018-1022.

[16] Schneck, J.; Fagot, J.P.; Sekula, P. Am. Acad. Dermatol. 2008, 58, 33-40.

[17] Phabphal, K.; Geater, A.; Limapichat, K. Epilepsia. 2013, 54, e94-e98.

[18] Hung, S.I.; Chung, W.H.; Chen,Y.T. Personalized Med. 2005, 2, 225-237.

[19] Lim, K.S.; Kwan, P.; Tan, C.T. Neurol. Asia. 2008, 13, 15-21.

[20] Farkas, R. Clinical Review. Adverse Events of Carbamazepine. 2007, Available at URL: http://www.fda.gov/cder/foi/nda/2007/016608s098, 020712s029,021710_ClinRev.pdf [search 26 Jan 2009].

[21] Tennis, P.; Stern, R.S. Neurology. 1997, 49, 542-600.

[22] Ayse, B.; Buyuktiryaki, N.; Handan, B.; Umit, M.S. Australasian J. Dermatol. 2012, 53, 274-277.

[23] Locharernkul, C.; Shotelersuk, V.; Hirankarn, N. J. Clin. Neurosci. 2011, 18, 1289-1294.

[24] Coppola, G. Epilepsia. 2009, 50, 49-51.

Hypersensitive syndrome reaction of antiepileptic drug: two case reports and literature review

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