Anticonvulsant hypersensitivity syndrome leading to reversible myocarditis.
A 67-year old Caucasian female was diagnosed with anticonvulsant hypersensitivity syndrome (AHS) after she developed the triad of high fevers, maculo-papular rash and internal organ involvement ten weeks after the institution of prophylactic phenytoin for resection of a meningioma. She developed congestive heart failure, with a substantial reduction in ejection fraction (EF) by an echocardiogram and serum cardiac enzyme elevation. In the setting of AHS, this was consistent with a drug-induced myocarditis. Treatment consisted of removal of the offending drug, diuretics and high dose steroids. Six weeks later her symptoms had completely resolved, with a return to a normal EF.
Zaidi
Ali N
AN
Dept. of Internal Medicine & Pediatrics, The Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA. azaidi@psu.edu
D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000628:therapy; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000628:therapy; D006801:Humans; D009205:Myocarditis / Q000209:etiology* / Q000628:therapy; D010672:Phenytoin / Q000009:adverse effects
D000927:Anticonvulsants; D002220:Carbamazepine; D010672:Phenytoin