title: Spectrum of anticonvulsant hypersensitivity syndrome: controversy of treatment.
abstract: An 18-month-old girl presented with a maculopapular rash 10 days after carbamazepine treatment. Initially, she was suspected of having a viral rash owing to associated fever. She deteriorated rapidly and was suspected of having anticonvulsant hypersensitivity syndrome or Stevens-Johnson syndrome. She developed features compatible with toxic epidermal necrolysis rapidly over 24 to 36 hours. Carbamazepine was then stopped. She responded immediately to high-dose intravenous pulse methylprednisone treatment. We discuss the controversy in the management of anticonvulsant hypersensitivity syndrome, toxic epidermal necrolysis, or Stevens-Johnson syndrome with high-dose corticosteroids, intravenous immunoglobulin, and antibiotics.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, University of Hong Kong, China.
authors.forename: Wing-Cheong
authors.initials: WC
authors.lastname: Lee
authors.forename: Joy Lok-Sum
authors.initials: JL
authors.lastname: Leung
authors.forename: Cheuk-Wing
authors.initials: CW
authors.lastname: Fung
authors.forename: Brian Hon-Yin
authors.initials: BH
authors.lastname: Chung
authors.forename: Virginia
authors.initials: V
authors.lastname: Wong
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008775:Methylprednisolone / Q000008:administration & dosage*; D020551:Pulse Therapy, Drug; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy* / Q000209:etiology*; D013577:Syndrome
chemical_list: D000927:Anticonvulsants; D005938:Glucocorticoids; D002220:Carbamazepine; D008775:Methylprednisolone