Spectrum of anticonvulsant hypersensitivity syndrome: controversy of treatment.
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.
Lee
Wing-Cheong
WC
Department of Paediatrics and Adolescent Medicine, University of Hong Kong, China.
Leung
Joy Lok-Sum
JL
Fung
Cheuk-Wing
CW
Chung
Brian Hon-Yin
BH
Wong
Virginia
V
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
D000927:Anticonvulsants; D005938:Glucocorticoids; D002220:Carbamazepine; D008775:Methylprednisolone