title: Drug rash with eosinophilia and systemic symptoms induced by valproate and carbamazepine: formation of circulating auto-antibody against 190-kDa antigen.
abstract: Drug rash with eosinophilia and systemic symptoms (DRESS) is characterized by fever, rash and internal organ involvement after exposure to certain drugs. Most of the aromatic anticonvulsants, such as phenytoin, phenobarbital, and carbamazepine, can induce DRESS. Cross-sensitivity between not only the aromatic anticonvulsants, but also the aromatic and non-aromatic anticonvulsants, is possible. We report here a case of a Korean woman who had previously tolerated valproate, but developed DRESS due to valproate after carbamazepine intake, which indicates cross-sensitivity. Her skin lesions displayed diffuse oedematous patches on the entire body associated with tense bullae on her arms and legs. Circulating auto-antibody to 190-kDa antigen was detected in the patient's serum by indirect immunofluorescence and immunoblotting, which might contribute to a pathogenic role in DRESS.
authors.affiliation: Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sook Jung
authors.initials: SJ
authors.lastname: Yun
authors.forename: Jee-Bum
authors.initials: JB
authors.lastname: Lee
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Kim
authors.forename: Gen
authors.initials: G
authors.lastname: Quan
authors.forename: Seong-Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Won
authors.forename: Seung-Chul
authors.initials: SC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects; D001323:Autoantibodies / Q000097:blood; D002220:Carbamazepine / Q000009:adverse effects; D003429:Cross Reactions; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D004802:Eosinophilia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D005260:Female; D006801:Humans; D014635:Valproic Acid / Q000009:adverse effects
chemical_list: D000927:Anticonvulsants; D001323:Autoantibodies; D002220:Carbamazepine; D014635:Valproic Acid