Mexiletine-induced severe skin eruption, fever, eosinophilia, atypical lymphocytosis, and liver dysfunction.
A 64-year-old man developed a severe generalized pruritic morbilliform skin eruption, fever, eosinophilia, atypical lymphocytosis, and liver dysfunction 30 days after ingestion of mexiletine, a sodium channel blocker, prescribed to treat postherpetic neuralgia. Following intravenous dexamethasone, body temperature normalized the next day. However, the skin eruption did not disappear completely for 4 weeks. The patch test was positive for mexiletine. Clinical features and the result of patch test indicated that the patient developed hypersensitivity syndrome, a severe adverse cutaneous drug reaction, caused by mexiletine. We propose that mexiletine be added to the list of drugs that can cause severe adverse cutaneous drug reactions and that patients receiving mexiletine be warned to stop taking the drug immediately if a skin eruption occurs.
Higa
K
K
Department of Anesthesiology, School of Medicine, Fukuoka University, Japan. higak@msat.fukuoka-u.ac.jp
Hirata
K
K
Dan
K
K
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000473:pathology; D003875:Drug Eruptions / Q000473:pathology; D004342:Drug Hypersensitivity / Q000097:blood / Q000473:pathology* / Q000503:physiopathology*; D004802:Eosinophilia / Q000139:chemically induced; D005334:Fever / Q000139:chemically induced; D006562:Herpes Zoster / Q000188:drug therapy; D006801:Humans; D008111:Liver Function Tests; D008218:Lymphocytosis / Q000139:chemically induced; D008297:Male; D008801:Mexiletine / Q000009:adverse effects*; D008875:Middle Aged
D000889:Anti-Arrhythmia Agents; D008801:Mexiletine